1
|
Anning KL, Langley K, Hobson C, van Goozen SHM. Cool and hot executive function problems in young children: linking self-regulation processes to emerging clinical symptoms. Eur Child Adolesc Psychiatry 2024; 33:2705-2718. [PMID: 38183461 PMCID: PMC11272683 DOI: 10.1007/s00787-023-02344-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024]
Abstract
Self-regulation (SR) difficulties are implicated in a wide range of disorders which develop in childhood, including attention deficit hyperactivity disorder (ADHD), oppositional defiance disorder (ODD), anxiety and depression. However, the integration of the existing research evidence is challenging because of varying terminology and the wide range of tasks used, as well as the heterogeneity and comorbidity within and across diagnostic categories. The current study used the Research Domain Criteria (RDoC) framework to guide the examination of different SR processes in young children showing a wide range of symptomatology. Children (aged 4-8) referred by teachers for moderate-to-high conduct, hyperactivity and/or emotional problems at school (assessed using the Strengths and Difficulties Questionnaire (SDQ) subscales; n = 212), and children in SDQ typical ranges (n = 30) completed computerised cognitive control and decision-making tasks. Parents completed questionnaires to assess ADHD, ODD, anxiety and depression symptoms (n = 191). Compared to children with no teacher-reported difficulties, those with moderate-to-high problems showed poorer visuomotor control and decision-making. A factor analysis revealed that task variables adhered to RDoC dimensions and predicted variance in specific disorders: difficulties in cognitive control predicted ADHD symptoms, low reward-seeking was associated with depression and high reward-seeking was associated with ODD. This study highlights how the assessment of cognitive processes positioned within the RDoC framework can inform our understanding of disorder-specific and transdiagnostic difficulties in SR which are associated with diverse clinical symptoms in children.
Collapse
Affiliation(s)
- Kate L Anning
- School of Psychology, Cardiff University, Cardiff, UK.
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.
| | - Kate Langley
- School of Psychology, Cardiff University, Cardiff, UK
| | | | | |
Collapse
|
2
|
Herbein M, Barbosa S, Collet O, Khalfallah O, Navarro M, Bailhache M, IV N, Aouizerate B, Sutter-Dallay AL, Koehl M, Capuron L, Ellul P, Peyre H, Van der Waerden J, Melchior M, Côté S, Heude B, Glaichenhaus N, Davidovic L, Galera C. Cord serum cytokines at birth and children's trajectories of mood dysregulation symptoms from 3 to 8 years: The EDEN birth cohort. Brain Behav Immun Health 2024; 38:100768. [PMID: 38586283 PMCID: PMC10990861 DOI: 10.1016/j.bbih.2024.100768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 03/28/2024] [Indexed: 04/09/2024] Open
Abstract
There is growing evidence that in utero imbalance immune activity plays a role in the development of neurodevelopmental and psychiatric disorders in children. Mood dysregulation (MD) is a debilitating transnosographic syndrome whose underlying pathophysiological mechanisms could be revealed by studying its biomarkers using the Research Domain Criteria (RDoC) model. Our aim was to study the association between the network of cord serum cytokines, and mood dysregulation trajectories in offsprings between 3 and 8 years of age. We used the data of a study nested in the French birth cohort EDEN that took place from 2003 to 2014 and followed mother-child dyads from the second trimester of pregnancy until the children were 8 years of age. The 2002 mother-child dyads were recruited from the general population through their pregnancy follow-up in two French university hospitals. 871 of them were included in the nested cohort and cord serum cytokine levels were measured at birth. Children's mood dysregulation symptoms were assessed with the Strengths and Difficulties Questionnaire Dysregulation Profile at the ages 3, 5 and 8 years in order to model their mood dysregulation trajectories. Out of the 871 participating dyads, 53% of the children were male. 2.1% of the children presented a high mood dysregulation trajectory whereas the others were considered as physiological variations. We found a significant negative association between TNF-α cord serum levels and a high mood dysregulation trajectory when considering confounding factors such as maternal depression during pregnancy (adjusted Odds Ratio (aOR) = 0.35, 95% Confidence Interval (CI) [0.18-0.67]). Immune imbalance at birth could play a role in the onset of mood dysregulation symptoms. Our findings throw new light on putative immune mechanisms implicated in the development of mood dysregulation and should lead to future animal and epidemiological studies.
Collapse
Affiliation(s)
- Marie Herbein
- University of Bordeaux, France
- INSERM, Bordeaux Population Health Center, UMR1219, France
- Centre Hospitalier Perrens, Bordeaux, France
| | - Susana Barbosa
- Université Côte d’Azur, Nice, France
- Centre National de Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
| | - Ophélie Collet
- University of Bordeaux, France
- Research Unit on Children's Psychosocial Maladjustment, Montreal, Canada
| | - Olfa Khalfallah
- Université Côte d’Azur, Nice, France
- Centre National de Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
| | - Marie Navarro
- University of Bordeaux, France
- INSERM, Bordeaux Population Health Center, UMR1219, France
| | - Marion Bailhache
- University of Bordeaux, France
- INSERM, Bordeaux Population Health Center, UMR1219, France
- Centre Hospitalier Universitaire de Bordeaux, Département de Pédiatrie, France
| | - Nicolas IV
- University of Bordeaux, France
- INSERM, Bordeaux Population Health Center, UMR1219, France
| | - Bruno Aouizerate
- University of Bordeaux, France
- Centre Hospitalier Perrens, Bordeaux, France
- INRAE, Bordeaux INP, NutriNeuro, UMR 1286, Bordeaux, France
| | - Anne-Laure Sutter-Dallay
- INSERM, Bordeaux Population Health Center, UMR1219, France
- Centre Hospitalier Perrens, Bordeaux, France
| | - Muriel Koehl
- University of Bordeaux, France
- INSERM, Neurocentre Magendie, UMR1215, Bordeaux, France
| | - Lucile Capuron
- University of Bordeaux, France
- INRAE, Bordeaux INP, NutriNeuro, UMR 1286, Bordeaux, France
| | - Pierre Ellul
- Robert Debré Hospital, Child and Adolescent department, APHP, Paris University, Paris, France
- Immunology-Immunopathology-Immunotherapy (i3), UMRS 959, INSERM, Paris, France
| | - Hugo Peyre
- Robert Debré Hospital, Child and Adolescent department, APHP, Paris University, Paris, France
- Centre de Ressource Autisme Languedoc-Roussillon et Centre d'Excellence sur l'Autisme et les Troubles du Neurodéveloppement (CeAND), CHU Montpellier, Montpellier, France
- Université Paris Saclay, UVSQ, Inserm, CESP, Tem DevPsy, 94807, Villejuif, France
| | - Judith Van der Waerden
- INSERM U1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Maria Melchior
- INSERM U1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Sorbonne Université, Équipe de Recherche en Épidémiologie Sociale, Paris, France
| | - Sylvana Côté
- University of Bordeaux, France
- INSERM, Bordeaux Population Health Center, UMR1219, France
- Research Unit on Children's Psychosocial Maladjustment, Montreal, Canada
- University of Montreal, Department of Social and Preventive Medicine, Montreal, Canada
| | - Barbara Heude
- Université de Paris, Centre for Research in Epidemiology and Statistics (CRESS), INSERM, INRAE, F-75004, Paris, France
- Paris University, France
| | - Nicolas Glaichenhaus
- Université Côte d’Azur, Nice, France
- Centre National de Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
- Fondation FondaMental, Créteil, France
| | - Laetitia Davidovic
- Université Côte d’Azur, Nice, France
- Centre National de Recherche Scientifique, Institut de Pharmacologie Moléculaire et Cellulaire, Valbonne, France
- Fondation FondaMental, Créteil, France
| | - Cedric Galera
- University of Bordeaux, France
- INSERM, Bordeaux Population Health Center, UMR1219, France
- Centre Hospitalier Perrens, Bordeaux, France
- Research Unit on Children's Psychosocial Maladjustment, Montreal, Canada
| |
Collapse
|
3
|
Bante A, Ayele G, Alamirew B, Ahmed M. Regulatory problems and associated factors among infants in Arba Minch health and demographic surveillance system sites, southern Ethiopia. PLoS One 2024; 19:e0305722. [PMID: 38889163 PMCID: PMC11185483 DOI: 10.1371/journal.pone.0305722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 06/03/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Infant regulatory problems are a common source of concern for parents, and they increase the risk of impaired infant-caregiver bonding. Despite their impact, they are often overlooked in Ethiopia. Hence, this study aimed to determine the prevalence and associated factors of infant regulatory problems in Arba Minch Health and Demographic Surveillance System sites in southern Ethiopia. METHODS A community-based cross-sectional study was conducted among 451 mother-infant pairs from February 15 to March 15, 2022. Regulatory problems were assessed using diagnostic interviews for regulatory problems. The data was collected using an open data kit Android application and analyzed with Stata version 17.0. Bivariable and multivariable logistic regression analyses were computed to identify factors associated with each infant regulatory problem. Statistical significance was declared at a p-value < 0.05. RESULTS In this study, four hundred forty-nine mother-infant pairs were involved, with a response rate of 99.5%. The prevalence of excessive crying, feeding problems, and sleeping difficulties was 14.03% [95% CI: 10.95, 17.59], 20.04% [95% CI: 16.44, 24.05], and 13.59% [95% CI: 10.55, 17.11], respectively. Attending primary education (AOR: 2.54, 95% CI: 1.22, 5.32), high perceived social support (AOR: 0.32, 95% CI: 0.12, 0.89), feeding problems (AOR: 5.0, 95% CI: 2.65, 9.45), and depression, anxiety, and stress (DAS) symptoms (AOR: 2.67, 95% CI: 1.19, 5.98) were associated with excessive crying. In addition, a family size of above five (AOR: 1.82, 95% CI: 1.03, 3.22), excessive crying (AOR: 3.76, 95% CI: 1.85, 7.65), sleeping problems (AOR: 2.29, 95% CI: 1.13, 4.65), comorbid DAS symptoms (AOR: 3.42, 95% CI: 1.64, 7.11), alcohol abuse (AOR: 1.89, 95% CI: 1.04, 3.42), and late initiation of complementary feeding (AOR: 2.67, 95% CI: 1.22, 5.88) were associated with feeding problems. Furthermore, attending primary education (AOR: 2.35, 95% CI: 1.16, 4.77), feeding problems (AOR: 3.47, 95% CI: 1.86, 6.48), and comorbid DAS symptoms (AOR: 3.23, 95% CI: 1.53, 6.84) were associated with sleeping problems. CONCLUSIONS Approximately one-third of infants encountered at least one regulatory problem. Level of education, perceived social support, feeding problems, and DAS symptoms were associated with excessive crying. Large family sizes, excessive crying, sleeping problems, comorbid DAS symptoms, alcohol abuse and, late initiation of complementary feeding increase the likelihood of feeding problems. Moreover, attending primary education, feeding problems, and comorbid DAS symptoms increase the odds of sleeping problems. Continuous guidance and support on infant soothing techniques, cognitive and behavioral therapy, and counselling on appropriate coping strategies for postpartum women are imperative to reduce the burden of infant regulatory problems.
Collapse
Affiliation(s)
- Agegnehu Bante
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Gistane Ayele
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Birhanu Alamirew
- School of Nursing, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| | - Muluken Ahmed
- School of Medicine, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
| |
Collapse
|
4
|
Brown MA, Gao MM, Isenhour J, Shakiba N, Crowell SE, Raby KL, Conradt E. Understanding emotion dysregulation from infancy to toddlerhood with a multilevel perspective: The buffering effect of maternal sensitivity. Dev Psychopathol 2024:1-14. [PMID: 38682545 DOI: 10.1017/s0954579424000774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
Abstract
Challenges with childhood emotion regulation may have origins in infancy and forecast later social and cognitive developmental delays, academic difficulties, and psychopathology. This study tested whether markers of emotion dysregulation in infancy predict emotion dysregulation in toddlerhood, and whether those associations depended on maternal sensitivity. When children (N = 111) were 7 months, baseline respiratory sinus arrhythmia (RSA), RSA withdrawal, and distress were collected during the Still Face Paradigm (SFP). Mothers' reports of infant regulation and orientation and maternal sensitivity were also collected at that time. Mothers' reports of toddlers' dysregulation were collected at 18 months. A set of hierarchical regressions indicated that low baseline RSA and less change in RSA from baseline to stressor predicted greater dysregulation at 18 months, but only for infants who experienced low maternal sensitivity. Baseline RSA and RSA withdrawal were not significantly associated with later dysregulation for infants with highly sensitive mothers. Infants who exhibited low distress during the SFP and who had lower regulatory and orienting abilities at 7 months had higher dysregulation at 18 months regardless of maternal sensitivity. Altogether, these results suggest that risk for dysregulation in toddlerhood has biobehavioral origins in infancy but may be buffered by sensitive caregiving.
Collapse
Affiliation(s)
| | - Mengyu Miranda Gao
- Department of Psychology, Beijing Normal University School of Psychology, Beijing, China
| | - Jennifer Isenhour
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Nila Shakiba
- Department of Psychology, Boston University, Boston, MA, USA
| | | | - K Lee Raby
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | | |
Collapse
|
5
|
Augustin M, Wenzel AS, Licata-Dandel M, Breeman LD, Bilgin A, Wolke D, Ziegler M, Mall V, Friedmann A. App-based intervention for parents of children with crying, sleeping, and feeding problems: Usability, usefulness and implications for improvement. Internet Interv 2024; 35:100700. [PMID: 38221943 PMCID: PMC10784306 DOI: 10.1016/j.invent.2023.100700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 11/29/2023] [Accepted: 12/11/2023] [Indexed: 01/16/2024] Open
Abstract
Background There is a lack of evidence-based app guidance for parents of children with crying, sleeping, and feeding problems who are often highly burdened and not likely to seek professional help. A new psychoeducational app for parents providing scientifically sound information via text and videos, a diary function, selfcare strategies, a chat forum and a regional directory of specialized counseling centers may serve as a low-threshold intervention for this target group. Objective We investigated how parents perceived the app in terms of the following: (1) overall impression and usability, (2) feedback on specific app functions regarding usefulness and (3) possible future improvements. Methods Our clinical sample of N = 137 parents of children aged from 0 to 24 months was recruited from a cry baby outpatient clinic in Southern Germany between 2019 and 2022. A convergent parallel mixed methods design was used to collect and analyse cross-sectional data on app evaluation. After app use within the framework of a clinical trial, parents filled in an app evaluation questionnaire. Results Most participants used the app at least once a week (86, 62.8 %) over an average period of 19.06 days (SD = 15.00). Participants rated overall impression and usability as good, and the informational texts, expert videos and regional register of counseling centers as appealing and useful. The diary function and chat forum were found to be helpful in theory, but improvements in implementation were requested, such as a timer function for the diary entry. Regarding future functionality, parents posed several suggestions such as the option to contact counseling centers directly via app, and the inclusion of the profile of their partners. Conclusions Positive ratings of overall impression, usability, and specific app functions are important prerequisites for the app to be effective. App-based guidance for this target group should include easy-to-use information. The app is intended to serve as a secondary preventive low-threshold offer and to complement professional counseling.
Collapse
Affiliation(s)
- Michaela Augustin
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Anne Sophie Wenzel
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Maria Licata-Dandel
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
- Department of Psychology, Charlotte-Fresenius-University, Infanteriestr.11a, 80797 Munich, Germany
| | - Linda D. Breeman
- Health, Medical, and Neuropsychology Unit, Leiden University, Wassenaarseweg 52, 2333 AK Leiden, Netherlands
| | - Ayten Bilgin
- Department of Psychology, University of Essex, Colchester CO4 3SQ, United Kingdom
| | - Dieter Wolke
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry CV4 7AL, United Kingdom
- Department of Psychology, University of Warwick, Coventry CV4 7HL, United Kingdom
| | - Margret Ziegler
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Volker Mall
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
- kbo-Kinderzentrum Munich, Heiglhofstr. 65, 81377 Munich, Germany
| | - Anna Friedmann
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Heiglhofstr. 65, 81377 Munich, Germany
| |
Collapse
|
6
|
Finlay-Jones AL, Ang JE, Brook J, Lucas JD, MacNeill LA, Mancini VO, Kottampally K, Elliott C, Smith JD, Wakschlag LS. Systematic Review and Meta-Analysis: Early Irritability as a Transdiagnostic Neurodevelopmental Vulnerability to Later Mental Health Problems. J Am Acad Child Adolesc Psychiatry 2024; 63:184-215. [PMID: 36863413 PMCID: PMC10460834 DOI: 10.1016/j.jaac.2023.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 01/16/2023] [Accepted: 02/21/2023] [Indexed: 03/04/2023]
Abstract
OBJECTIVE Irritability is a transdiagnostic indicator of child and adolescent internalizing and externalizing problems that is measurable from early life. The objective of this systematic review was to determine the strength of the association between irritability measured from 0 to 5 years and later internalizing and externalizing problems, to identify mediators and moderators of these relationships, and to explore whether the strength of the association varied according to irritability operationalization. METHOD Relevant studies published in peer-reviewed, English-language journals between the years 2000 and 2021 were sought from EMBASE, PsycINFO, MEDLINE, CINAHL, and ERIC. We synthesized studies that included a measure of irritability within the first 5 years of life and reported associations with later internalizing and/or externalizing problems. Methodological quality was assessed using the JBI-SUMARI Critical Appraisal Checklist. RESULTS Of 29,818 identified studies, 98 met inclusion criteria, with a total number of 932,229 participants. Meta-analysis was conducted on 70 studies (n = 831,913). Small, pooled associations were observed between infant irritability (0-12 months) and later internalizing (r = 0.14, 95% CI = 0.09, 0.20) and externalizing symptoms (r = 0.16, 95% CI = 0.11, 0.21) symptoms. For toddler/preschool irritability (13-60 months), small-to-moderate pooled associations were observed for internalizing (r = 0.21, 95% CI = 0.14, 0.28) and externalizing (r = 0.24, 95% CI = 0.18, 0.29) symptoms. These associations were not moderated by the lag between irritability and outcome assessment, although the strength of the associations varied according to irritability operationalization. CONCLUSION Early irritability is a consistent transdiagnostic predictor of internalizing and externalizing symptoms in childhood and adolescence. More work is required to understand how to accurately characterize irritability across this developmental period, and to understand mechanisms underlying the relationship between early irritability and later mental health problems. DIVERSITY & INCLUSION STATEMENT One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. One or more of the authors of this paper self-identifies as living with a disability. We actively worked to promote sex and gender balance in our author group. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. STUDY PREREGISTRATION INFORMATION Early irritability as a transdiagnostic neurodevelopmental vulnerability to early onset mental health problems: A systematic review; https://www.crd.york.ac.uk/prospero/; CRD42020214658.
Collapse
Affiliation(s)
- Amy L Finlay-Jones
- Telethon Kids Institute, Nedlands, Western Australia; Curtin University, Bentley, Western Australia; University of Western Australia, Crawley, Western Australia.
| | | | - Juliet Brook
- Telethon Kids Institute, Nedlands, Western Australia
| | | | | | | | | | - Catherine Elliott
- Telethon Kids Institute, Nedlands, Western Australia; Curtin University, Bentley, Western Australia
| | | | | |
Collapse
|
7
|
D'Cruz AFL, Downing KL, Sciberras E, Hesketh KD. Are physical activity and sleep associated with emotional self-regulation in toddlers? a cross-sectional study. BMC Public Health 2024; 24:61. [PMID: 38166760 PMCID: PMC10763404 DOI: 10.1186/s12889-023-17588-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 12/26/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Toddlerhood (2-3 years) is a crucial period for the development of physical activity, sleep, and emotional self-regulation skills. Although there is growing evidence of positive associations between physical activity, sleep, and emotional self-regulation in school-aged children, the associations in toddlers remain unclear. Thus, this study aimed to examine the association between physical activity, sleep, and emotional self-regulation in toddlers. METHODS Baseline data from 1350 toddlers (2.2 ± 0.33 year) from the Let's Grow randomised controlled trial were used. Toddlers' total physical activity (TPA) and moderate- to vigorous-intensity physical activity (MVPA) were assessed via 4 + days of accelerometry and a 3-item parent-report scale. Parent-reported total sleep quantity was calculated using the sum of average night-time sleep and daytime nap durations. Sleep behaviour data including bedtime routine, bedtime resistance, sleep onset-delay, sleep duration, and night waking were collected using relevant subsections from the Child Sleep Habits Questionnaire (CSHQ) and Brief Infant Sleep Questionnaire revised (BISQ-R). A 4-item parent-report scale adapted from the Fast Track Project Child Behaviour Questionnaire was used to assess toddlers' emotional self-regulation. Linear regression models were used, adjusting for child age, sex, and parental education. RESULTS Accelerometer-derived TPA, MVPA and parent-reported TPA were not associated with emotional self-regulation. Higher parent-reported MVPA (B = -0.01 CI95 -0.03, -0.003) was associated with poorer emotional self-regulation. Higher sleep duration was associated with better emotional self-regulation (B = 0.06 CI95 0.04, 0.08). The five sleep behaviours assessed were also positively associated with emotional self-regulation (all p < 0.01), with fewer problem sleep behaviours being associated with better emotional self-regulation. CONCLUSIONS This cross-sectional study suggests that sleep may be important for emotional self-regulation in toddlers, but the role of physical activity remains unclear. These findings suggest that interventions targeting sleep duration and sleep behaviours during the early toddler years may benefit the positive development of emotional self-regulation skills in this population.
Collapse
Affiliation(s)
- Abhigale F L D'Cruz
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia.
| | - Katherine L Downing
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| | - Emma Sciberras
- Centre for Social and Early Emotional Development (SEED), School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Kylie D Hesketh
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, VIC, Australia
| |
Collapse
|
8
|
Bradley H, Fine D, Minai Y, Gilabert L, Gregory K, Smith L, Gao W, Giase G, Krogh-Jespersen S, Zhang Y, Wakschlag L, Brito NH, Feliciano I, Thomason M, Cabral L, Panigrahy A, Potter A, Cioffredi LA, Smith BA. Maternal perceived stress and infant behavior during the COVID-19 pandemic. Pediatr Res 2023; 94:2098-2104. [PMID: 37500757 PMCID: PMC10665182 DOI: 10.1038/s41390-023-02748-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 06/07/2023] [Accepted: 07/09/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Maternal stress has negative consequences on infant behavioral development, and COVID-19 presented uniquely stressful situations to mothers of infants born during the pandemic. We hypothesized that mothers with higher levels of perceived stress during the pandemic would report higher levels of infant regulatory problems including crying and interrupted sleep patterns. METHODS As part 6 sites of a longitudinal study, mothers of infants born during the pandemic completed the Perceived Stress Scale, the Brief Infant Sleep Questionnaire, and an Infant Crying survey at 6 (n = 433) and 12 (n = 344) months of infant age. RESULTS Maternal perceived stress, which remained consistent at 6 and 12 months of infant age, was significantly positively correlated with time taken to settle infants. Although maternal perceived stress was not correlated with uninterrupted sleep length, time taken to put the infant to sleep was correlated. Perceived stress was also correlated with the amount of infant crying and fussiness reported at 6 months. CONCLUSIONS Mothers who reported higher levels of perceived stress during the pandemic reported higher levels of regulatory problems, specifically at 6 months. Examining how varying levels of maternal stress and infant behaviors relate to overall infant developmental status over time is an important next step. IMPACT Women giving birth during the COVID-19 pandemic who reported higher levels of stress on the Perceived Stress Scale also reported higher levels of infant fussiness and crying at 6 months old, and more disruptive sleep patterns in their infants at 6 months and 12 months old. Sleeping problems and excessive crying in infancy are two regulatory problems that are known risk factors for emotional and behavioral issues in later childhood. This paper is one of the first studies highlighting the associations between maternal stress and infant behaviors during the COVID-19 pandemic.
Collapse
Affiliation(s)
- Holly Bradley
- Developmental Behavioral Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Dana Fine
- Developmental Behavioral Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - Yasmin Minai
- Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA, USA
| | - Laurel Gilabert
- Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA, USA
| | - Kimberly Gregory
- Cedars-Sinai Medical Center, Department of Obstetrics and Gynecology, Los Angeles, CA, USA
| | - Lynne Smith
- Harbor-UCLA Medical Center Department of Pediatrics, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Wei Gao
- Cedars-Sinai Medical Center, Biomedical Imaging Research Institute, Los Angeles, CA, USA
| | - Gina Giase
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | | | - Yudong Zhang
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Lauren Wakschlag
- Department of Medical Social Sciences, Northwestern University, Chicago, IL, USA
| | - Natalie H Brito
- Department of Applied Psychology, New York University, New York, NY, USA
| | - Integra Feliciano
- Department of Child and Adolescent Psychiatry, New York University, New York, NY, USA
| | - Moriah Thomason
- Department of Child and Adolescent Psychiatry, New York University, New York, NY, USA
| | - Laura Cabral
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Ashok Panigrahy
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Alexandra Potter
- University of Vermont Medical Center, Psychiatry, Burlington, VT, USA
| | - Leigh-Anne Cioffredi
- Department of Pediatrics, University of Vermont Medical Center, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Beth A Smith
- Developmental Behavioral Pediatrics, Children's Hospital Los Angeles, Los Angeles, CA, USA.
- The Saban Research Institute, Children's Hospital Los Angeles, Los Angeles, CA, USA.
- Department of Pediatrics, University of Southern California, Los Angeles, CA, USA.
| |
Collapse
|
9
|
Holla C, Thomas B, Kishore MT. Parenting toddlers: Evidences of parental needs from South India. Int J Soc Psychiatry 2023; 69:2079-2086. [PMID: 37462317 DOI: 10.1177/00207640231188032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
BACKGROUND Quality of childcare can predict a child's emotional and behavioural adjustment throughout the life span. Furthermore, this has major implications for child development and mental health in the long-term. Parents often face major challenges while providing childcare especially during the early years of a child. AIM This paper describes specific parental concerns in raising a toddler from a mental health developmental perspective. METHODS The study was conducted in urban Bengaluru, India under an exploratory research design using semi-structured interviews. Ten parents participated in the study. Data was analysed using thematic analysis. RESULTS Four major themes emerged. The first theme was related to the formation of parental beliefs about parenting which identified several sources such as parenting practices witnessed during childhood, childhood experiences and influence of culture, mass or social media. The second theme to emerge was on concerns related to toddlers which parents had difficulties in understanding as well as managing, specially navigating through sleep and feed pattern, identifying developmental needs and making a meaning of toddlers' communication styles and content. The third theme showed parental concerns which consisted of areas such as parental stress, physical exhaustion, lack of time for each other or toddler, lack of information about handling toddlers and absence of validation of parental efforts. The final theme was on their current parenting practices with their toddlers which showcased controlling styles, play time but low on quality, inappropriate responses to toddlers' emotions or behaviours and several culturally practiced measures which were not validated scientifically. CONCLUSION The pre-existing belief among parents about parenting and toddlers' specific behaviours influence parenting practices. The understanding of the parental challenges is beneficial in developing an appropriate parenting programme focussing on strengthening psychological capacities of toddlers.
Collapse
Affiliation(s)
- Chaithra Holla
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Bino Thomas
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| | - Madhavaram Thomas Kishore
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, Karnataka, India
| |
Collapse
|
10
|
Ahmad S, Peterson ER, Waldie KE, Morton SMB. Proximal Processes and Contextual Factors Associated with Early Socio-emotional Competence Development. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01591-0. [PMID: 37717222 DOI: 10.1007/s10578-023-01591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2023] [Indexed: 09/19/2023]
Abstract
There is growing interest in child socio-emotional competence from parents, educators, employers and policy makers, with emphasis on developing it as early as possible. The aim of the present study was to examine contextual and proximal factors that influence socio-emotional competence development across the first five years of a child's life. We used data from 3200 mothers and their children drawn mostly from four major data collection waves (antenatal, 9 months, 2 years and 4.5 years) of the population-based longitudinal study, Growing Up in New Zealand. Regression analyses were carried out to identify the predictors of socio-emotional competence after controlling for demographics and prior score(s) of socio-emotional competence. We found that specific maternal behaviours, such as playing games and playing with toys with children, singing songs or telling stories to them, reading books with them, having rules around viewing TV, DVDs and videos, and praising children have a positive effect on socio-emotional competence. Parental relationship warmth and less family stress at 9 months also made positive contributions to socio-emotional competence at 9 months and 2 years. In contrast, attending childcare and having more siblings at home negatively predicted socio-emotional competence at 9 months. Mother's unemployment, living in neighbourhoods perceived as negative and being in contact with family and social services were negatively associated with concurrent socio-emotional competence at 2 years. Overall, more and/or stronger contemporaneous effects were found suggesting that negative effects of contextual factors may not have lasting impact on socio-emotional competence. In addition, the results showed that maternal behaviours need to be practised regularly to have positive impact on child's socio-emotional development.
Collapse
Affiliation(s)
- Sahrish Ahmad
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand.
| | - Elizabeth R Peterson
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, Centre for Longitudinal Research-He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Karen E Waldie
- School of Psychology, Faculty of Science, The University of Auckland, Auckland, New Zealand
- Growing Up in New Zealand, Centre for Longitudinal Research-He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| | - Susan M B Morton
- Growing Up in New Zealand, Centre for Longitudinal Research-He Ara ki Mua, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
11
|
Asmussen J, Davidsen KA, Olsen AL, Skovgaard AM, Bilenberg N. The longitudinal association of combined regulatory problems in infancy and mental health outcome in early childhood: a systematic review. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02262-0. [PMID: 37493835 DOI: 10.1007/s00787-023-02262-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 07/07/2023] [Indexed: 07/27/2023]
Abstract
Co-occurring regulatory problems in infancy, RPs, including excessive crying, feeding-eating and sleeping, have been found associated with mental health problems in school ages. Still, an overview is needed on trajectories of co-occurring or combined RPs, and mental health problems in early childhood. The aim of this review is to systematically review the literature on longitudinal community-based studies of combined RPs measuring mental health outcomes in early childhood. Following the PRISMA guideline, we systematically reviewed the literature published 2000-2020, in which combined RPs are assessed in infancy, and mental health is examined using standardised measures at ages 1-7 years. The search was performed in four databases MEDLINE, EMBASE, PsycINFO and Scopus. A protocol is published on PROSPERO. Based on 1978 screened articles, 42 papers were screened for eligibility, of which six were included, comprising data on two or more RPs investigated among a total of 20,675 children. Assessment of risk of bias in the studies showed overall good quality in five of the six papers. The literature reviewed suggests that combined RPs in infancy are early markers of mental health problems during early childhood, and highlights that community studies exploring the longitudinal associations of combined RP and mental health problems in preschool and early school age are still scarce. Overall, the review points to the need of research into preventive intervention targeting early manifestations of childhood dysregulation, such as RPs.
Collapse
Affiliation(s)
- Jette Asmussen
- Department of Clinical Research, Research Unit of Child and Adolescent Mental Health, University of Southern Denmark, J.B Winsløws Vej 16, 5000, Odense C, Denmark.
| | - Kirstine Agnete Davidsen
- Department of Psychology, University of Southern Denmark, Mental Health Services, Region of Southern Denmark, Research Unit &, Odense, Denmark
| | - Anne Lise Olsen
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Copenhagen, Denmark
| | - Anne Mette Skovgaard
- Faculty of Health Sciences, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Niels Bilenberg
- Research Unit of Child and Adolescent Psychiatry Odense, Odense, Denmark
| |
Collapse
|
12
|
Muzard A, Olhaberry M, Nuñez C, Vaccarezza S, Franco P, Morán J, Sieverson C, León MJ, Apter G. Parental personality traits and emotion regulation: Its relationship with infants' socioemotional development during the perinatal period. Gen Hosp Psychiatry 2023; 83:20-26. [PMID: 37030058 DOI: 10.1016/j.genhosppsych.2023.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/27/2023] [Accepted: 04/02/2023] [Indexed: 04/10/2023]
Abstract
Socioemotional development is central throughout life, and it unfolds in an interpersonal context in which each significant caregiver has an impact, particularly during infancy. However, only a relatively small number of studies have investigated associations between mothers and fathers' personality and emotional characteristics with their infant's socioemotional development during the perinatal period. Therefore, the present article examines the relationship between maternal and paternal personality traits and emotion regulation difficulties during the prenatal period with offspring's socioemotional development. This was a non-experimental and longitudinal study that included a community sample of 55 mother-father-baby triads. Parental assessments were carried out between the second and third trimester of pregnancy, and baby's socio-emotional development was assessed during their 2nd month after birth. Results evidenced differences between maternal and paternal personality traits and emotion regulation difficulties during the perinatal period as well as distinct contributions on infant's socioemotional development.
Collapse
Affiliation(s)
- Antonia Muzard
- Psychotherapy, School of Psychology, Pontificia Universidad Católica de Chile, Millennium Institute for Research in Depression and Personality (MIDAP), Chile; School of Psychology, Universidad Finis Terrae, Santiago, Chile.
| | - Marcia Olhaberry
- School of Psychology, Pontificia Universidad Católica de Chile, Millennium Institute for Research in Depression and Personality (MIDAP), Chile.
| | - Catalina Nuñez
- Psychotherapy, School of Psychology, Pontificia Universidad Católica de Chile, Millennium Institute for Research in Depression and Personality (MIDAP), Chile; School of Psychology, Universidad Finis Terrae, Santiago, Chile; School of Psychology, Universidad Adolfo Ibañez, Santiago, Chile.
| | - Stephanie Vaccarezza
- Psychotherapy, School of Psychology, Pontificia Universidad Católica de Chile; School of Psychology, Universidad de Chile; Millennium Institute for Research in Depression and Personality (MIDAP), Chile; School of Psychology, Universidad Finis Terrae, Santiago, Chile.
| | - Pamela Franco
- Doctoral Program in Psychotherapy, School of Psychology, Pontificia Universidad Católica de Chile; Millennium Institute for Research in Depression and Personality (MIDAP), Chile.
| | - Javier Morán
- School of Psychology, Universidad de Valparaiso, Chile; Millennium Institute for Research in Depression and Personality (MIDAP); Fundación Mente en Mente, Chile.
| | - Catalina Sieverson
- School of Psychology, Pontificia Universidad Católica de Chile; Millennium Institute for Research in Depression and Personality (MIDAP), Chile.
| | - María José León
- Millennium Institute for Research in Depression and Personality (MIDAP); Fundación Mente en Mente, Chile.
| | - Gisele Apter
- Doctoral Program in Psychotherapy, Université de Rouen Normandie, Groupe Hospitalier du Havre, France.
| |
Collapse
|
13
|
Kahn M, Barnett N, Gradisar M. Implementation of Behavioral Interventions for Infant Sleep Problems in Real-World Settings. J Pediatr 2023; 255:137-146.e2. [PMID: 36375604 DOI: 10.1016/j.jpeds.2022.10.038] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To compare the real-world frequency, timing, duration, difficulty, and helpfulness of 3 infant Behavioral Sleep Intervention (BSI) approaches: Unmodified Extinction, Modified Extinction, and Parental Presence and to examine the effectiveness and safety of these approaches by comparing infant sleep, parent sleep, daytime sleepiness, depression, and parent-infant bonding between parents who had and had not implemented these interventions. STUDY DESIGN Participants were 2090 parents (75% mothers, 79% White/Caucasian) of US infants (49% girls) aged 3-18 months (M = 9.1, SD = 4.1). Parents completed online questionnaires regarding their infant's sleep, their own sleep, daytime sleepiness, depression levels, and parent-infant bonding. Infant sleep was assessed via objective-albeit exploratory-autovideosomnography data obtained from the 14 days prior to survey completion. RESULTS Sixty-four percent of parents reported implementing BSIs. The average age at intervention was 5.3 months (SD = 2.6). Unmodified and Modified Extinction were rated as significantly more difficult to implement compared with Parental Presence but also as more helpful, shorter, and quicker to show improvements. Infant nighttime sleep was longer and more consolidated in the Unmodified and Modified Extinction groups compared with the Parental Presence and non-BSI groups. No differences were found between BSI groups in parent sleep, sleepiness, depression, or parent-infant bonding. CONCLUSIONS Implementation of BSIs outside clinical settings is pervasive and occurs earlier than generally recommended. Unmodified and Modified Extinction were associated with longer and more consolidated infant sleep. Despite concerns regarding the potential harm of BSIs, implementation of these approaches was not linked with negative outcomes, providing additional evidence for their safety and effectiveness.
Collapse
Affiliation(s)
- Michal Kahn
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia.
| | | | - Michael Gradisar
- Wink Sleep Pty Ltd, Adelaide, South Australia, Australia; Sleep Cycle AB, Gothenburg, Sweden
| |
Collapse
|
14
|
Augustin M, Licata-Dandel M, Breeman LD, Harrer M, Bilgin A, Wolke D, Mall V, Ziegler M, Ebert DD, Friedmann A. Effects of a Mobile-Based Intervention for Parents of Children With Crying, Sleeping, and Feeding Problems: Randomized Controlled Trial. JMIR Mhealth Uhealth 2023; 11:e41804. [PMID: 36897641 PMCID: PMC10039405 DOI: 10.2196/41804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 12/16/2022] [Accepted: 01/13/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Excessive crying, sleeping, and feeding problems in early childhood are major stressors that can result in parents feeling socially isolated and having low self-efficacy. Affected children are a risk group for being maltreated and developing emotional and behavioral problems. Thus, the development of an innovative and interactive psychoeducational app for parents of children with crying, sleeping, and feeding problems may provide low-threshold access to scientifically based information and reduce negative outcomes in parents and children. OBJECTIVE We aimed to investigate whether following the use of a newly developed psychoeducational app, the parents of children with crying, sleeping, or feeding problems experienced less parenting stress; gained more knowledge about crying, sleeping, and feeding problems; and perceived themselves as more self-effective and as better socially supported and whether their children's symptoms decreased more than those of the parents who did not use the app. METHODS Our clinical sample consisted of 136 parents of children (aged 0-24 months) who contacted a cry baby outpatient clinic in Bavaria (Southern Germany) for an initial consultation. Using a randomized controlled design, families were randomly allocated to either an intervention group (IG; 73/136, 53.7%) or a waitlist control group (WCG; 63/136, 46.3%) during the usual waiting time until consultation. The IG was given a psychoeducational app that included evidence-based information via text and videos, a child behavior diary function, a parent chat forum and experience report, tips on relaxation, an emergency plan, and a regional directory of specialized counseling centers. Outcome variables were assessed using validated questionnaires at baseline test and posttest. Both groups were compared at posttest regarding changes in parenting stress (primary outcome) and secondary outcomes, namely knowledge about crying, sleeping, and feeding problems; perceived self-efficacy; perceived social support; and child symptoms. RESULTS The mean individual study duration was 23.41 (SD 10.42) days. The IG reported significantly lower levels of parenting stress (mean 83.18, SD 19.94) after app use compared with the WCG (mean 87.46, SD 16.67; P=.03; Cohen d=0.23). Furthermore, parents in the IG reported a higher level of knowledge about crying, sleeping, and feeding (mean 62.91, SD 4.30) than those in the WCG (mean 61.15, SD 4.46; P<.001; Cohen d=0.38). No differences at posttest were found between groups in terms of parental efficacy (P=.34; Cohen d=0.05), perceived social support (P=.66; Cohen d=0.04), and child symptoms (P=.35; Cohen d=0.10). CONCLUSIONS This study provides initial evidence of the efficacy of a psychoeducational app for parents with child crying, sleeping, and feeding problems. By reducing parental stress and increasing knowledge of children's symptoms, the app has the potential to serve as an effective secondary preventive measure. Additional large-scale studies are needed to investigate long-term benefits. TRIAL REGISTRATION German Clinical Trials Register DRKS00019001; https://drks.de/search/en/trial/DRKS00019001.
Collapse
Affiliation(s)
- Michaela Augustin
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Maria Licata-Dandel
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
- kbo-Kinderzentrum Munich, Munich, Germany
| | - Linda D Breeman
- Health, Medical, and Neuropsychology Unit, Leiden University, Leiden, Netherlands
| | - Mathias Harrer
- Psychology & Digital Mental Health Care, Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
- Clinical Psychology and Psychotherapy, Institute for Psychology, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Ayten Bilgin
- School of Psychology, University of Kent, Canterbury, United Kingdom
| | - Dieter Wolke
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, United Kingdom
- Department of Psychology, University of Warwick, Coventry, United Kingdom
| | - Volker Mall
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
- kbo-Kinderzentrum Munich, Munich, Germany
| | | | - David Daniel Ebert
- Psychology & Digital Mental Health Care, Department of Sports and Health Sciences, Technical University of Munich, Munich, Germany
| | - Anna Friedmann
- Social Pediatrics, TUM School of Medicine, Technical University of Munich, Munich, Germany
| |
Collapse
|
15
|
Sammallahti S, Serdarevic F, Tiemeier H. Excessive Crying, Behavior Problems, and Amygdala Volume: A Study From Infancy to Adolescence. J Am Acad Child Adolesc Psychiatry 2023; 62:675-683. [PMID: 36758936 DOI: 10.1016/j.jaac.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 09/30/2022] [Accepted: 01/31/2023] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Excessive crying in infancy has been associated with increased risk of later behavioral problems. To identify individuals at risk for behavioral problems and to understand the mechanisms underlying excessive crying and irritability in infancy, research into the neurobiology of excessive crying is needed. We examined whether excessive crying and irritability in infancy are associated with behavioral problems and amygdala volume among children and adolescents. METHOD This study included 4,751 singleton children from the prospective population-based Generation R Study cohort, born in the Netherlands in 2002 to 2006. Excessive crying (>3 hours on at least 1 day/wk) and irritability (Mother and Baby Scales questionnaire) were parent-rated at 3 months. Amygdala volume was measured at 10 years using magnetic resonance imaging, and internalizing and externalizing were parent-rated at 1.5, 3, 6, 10, and 14 years and self-rated at 14 years. Covariates included child age, sex, national origin, gestational age, and maternal age, psychopathology score, parity, education, relationship status, and family income. RESULTS Children who cried excessively in infancy had higher parent-rated internalizing (effect estimate = 0.20 SD-units, 95% CI = 0.14, 0.27) and externalizing (0.17 SD-units, 95% CI = 0.10, 0.24) throughout childhood (linear mixed models), and smaller amygdala volume at 10 years (-0.19 SD-units, 95% CI = -0.32, -0.06) (linear regression model). The pattern of associations for both behavioral problems and amygdala volume was similar for irritability. CONCLUSION Excessive crying and irritability in infancy may reflect an early vulnerability to behavioral problems and may be linked with neurobiological differences in the development of the amygdala.
Collapse
Affiliation(s)
- Sara Sammallahti
- Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands; University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
| | | | - Henning Tiemeier
- Erasmus MC, Sophia Children's Hospital, Rotterdam, the Netherlands; Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
16
|
Evers O, Georg AK, Wegener C, Sidor A, Taubner S. Transactional Relations between Child Functioning and Parenting Stress in the First Years of Life: A Longitudinal Study among Psychosocially Burdened Families. Psychopathology 2023; 56:29-40. [PMID: 35537443 DOI: 10.1159/000524101] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 03/13/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Previous research reported transactional relations between child functioning and parenting stress. There is limited evidence whether a transactional developmental model also fits children below the age of 12 months, especially in psychosocially burdened families. This study aims to test the fit of a transactional model during the first 3 years of life and examines whether the model differs between families with low and high psychosocial burden. METHODS A total of 302 psychosocially burdened families were observed over 3 years at age 4, 12, 24, and 36 months. Child behavioral problems and parenting stress were assessed via self-report while psychosocial burden was assessed via external rating at baseline. Cross-lagged panel analysis was used to investigate the fit of a transactional model. RESULTS A transactional model fitted the data significantly better (Δχ2 = 81.87, p < 0.001) than an autoregressive model reaching acceptable to good fit indices (CFI = 0.96, RMSEA = 0.09). The model indicated moderate stability within and reciprocal effects between child behavioral problems and parenting stress from age 12 to 36 months. From age 4 to 12 months, parenting stress predicted child behavioral problems but not vice-versa. Model fit indices and transactional relations did not substantially differ between families with low and high psychosocial burden, except for child effects on parenting stress during the first year of life, which were only evident in higher burdened families. CONCLUSION Transactional relations among child and parent variables are evident in the first 3 years of life. Child effects in the first year of life may be restricted to highly psychosocially burdened families. Future research may focus on potential mediating variables such as parental sensitivity or contextual variables like significant life events. Targeted prevention strategies should be adapted to the level of psychosocial burden to account for the differing transactional relations.
Collapse
Affiliation(s)
- Oliver Evers
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany.,Department of Psychosomatic Medicine and Psychotherapy, Medical Center Freiburg, Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Anna Katharina Georg
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Charlotte Wegener
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| | - Anna Sidor
- Social Pediatric Centre Frankfurt, Frankfurt, Germany
| | - Svenja Taubner
- Institute for Psychosocial Prevention, Heidelberg University Hospital, Heidelberg University, Heidelberg, Germany
| |
Collapse
|
17
|
Putnick DL, Bell EM, Ghassabian A, Polinski KJ, Robinson SL, Sundaram R, Yeung E. Associations of toddler mechanical/distress feeding problems with psychopathology symptoms five years later. J Child Psychol Psychiatry 2022; 63:1261-1269. [PMID: 35048380 PMCID: PMC9294067 DOI: 10.1111/jcpp.13567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Feeding problems are common in early childhood, and some evidence suggests that feeding problems may be associated with psychopathology. Few prospective studies have explored whether toddler feeding problems predict later psychopathology. METHODS Mothers of 1,136 children from the Upstate KIDS cohort study provided data when children were 2.5 and 8 years of age. Food refusal (picky eating) and mechanical/distress feeding problems and developmental delays were assessed at 2.5 years. Child eating behaviors (enjoyment of food, food fussiness, and emotional under and overeating) and child psychopathology (attention-deficit/hyperactivity (ADHD), oppositional-defiant (OD), conduct disorder (CD), and anxiety/depression) symptoms were assessed at 8 years. RESULTS Mechanical/distress feeding problems at age 2.5, but not food refusal problems, were associated with ADHD, problematic behavior (OD/CD), and anxiety/depression symptoms at 8 years in models adjusting for eating behaviors at 8 years and child and family covariates. Associations with mechanical/distress feeding problems were larger for ADHD and problematic behavior than anxiety/depression symptoms, though all were modest. Model estimates were similar for boys and girls. CONCLUSIONS Much of the research on feeding problems focuses on picky eating. This study suggests that early mechanical and mealtime distress problems may serve as better predictors of later psychopathology than food refusal. Parents and pediatricians could monitor children with mechanical/distress feeding problems for signs of developing psychopathology.
Collapse
Affiliation(s)
- Diane L. Putnick
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Erin M. Bell
- Department of Environmental Health Sciences, University at Albany School of Public Health
| | - Akhgar Ghassabian
- Departments of Pediatrics, Environmental Medicine, and Population Health, New York University Grossman School of Medicine
| | - Kristen J. Polinski
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Sonia L. Robinson
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Rajeshwari Sundaram
- Biostatistics and Bioinformatics Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| | - Edwina Yeung
- Epidemiology Branch, Division of Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health
| |
Collapse
|
18
|
Schnatschmidt M, Lollies F, Schlarb AA. Can a parental sleep intervention in an individual setting improve the maternal and paternal sense of competence and parent-child interaction in parents of young sleep-disturbed children? findings from a single-arm pilot intervention study. BMC Psychol 2022; 10:243. [PMID: 36316716 PMCID: PMC9623967 DOI: 10.1186/s40359-022-00945-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 09/07/2022] [Accepted: 10/07/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In early childhood sleep and regulatory problems, parental factors are often impaired but essential to overcoming them. This study aims to examine, in parents of young sleep-disturbed children, whether mothers' and fathers' sense of parenting competence were increased and dysfunctional parent-child interactions reduced with a parental sleep intervention, whether these changes were sustained over a 12-month follow-up period and if children's symptomatic parameters could be related factors. METHODS A total of 57 families with sleep-disturbed children aged 6 months to 4 years entered this single-arm pilot study. Each parent pair participated in six weekly individual face-to-face sessions of a multimodal cognitive-behavioral sleep intervention. The Parenting Sense of Competence Scale, Parental Stress Index Short Form, Child's Sleep Diary and Child's Questionnaire on Crying, Eating and Sleeping were obtained pre-, post-, 3, 6 and 12 months after the intervention. RESULTS Maternal sense of competence and dysfunctional mother-child interaction improved significantly up to 6 months after the intervention. Factors related to lower maternal competence were the child's more frequent nightly food intake and more crying due to defiance; factors related to dysfunctional mother-child interaction were more frequent crying episodes, more crying due to defiance and more eating difficulties; factors related to increased maternal competence were less duration of child's night waking, less bed-sharing and lower frequency of crying episodes; factors related to increased paternal competence were less child's nightly food intake and fewer episodes of unexplained and unsoothable crying; and factors related to improved father-child interaction were less frequent child's night waking and fewer unexplained and unsoothable crying episodes. CONCLUSION For parents of sleep-disturbed young children, an intervention that addresses the child's sleep could be promising to increase the parental sense of competence and reduce dysfunctional parent-child interactions, especially for mothers. Child symptomatic parameters may change, together with the parental sense of competence and parent-child interaction of both parents, after the intervention. Mothers with children with more severe symptomatology perceive their parenting competence as lower on average and their mother-child interaction as more dysfunctional. Future research with a larger sample and a randomized controlled design is needed. TRIAL REGISTRATION The study was retrospectively registered at the German Clinical Trials Register (ID: DRKS00028578; registration date: 21.03.2022).
Collapse
Affiliation(s)
- Marisa Schnatschmidt
- grid.7491.b0000 0001 0944 9128Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501 Bielefeld, Germany
| | - Friederike Lollies
- grid.7491.b0000 0001 0944 9128Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501 Bielefeld, Germany
| | - Angelika A. Schlarb
- grid.7491.b0000 0001 0944 9128Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501 Bielefeld, Germany
| |
Collapse
|
19
|
Antoniou F, Al-Khadim GS. Validity of social–emotional screening tool for newborns and infants: The effects of gender, ethnicity and age. Front Psychol 2022; 13:960086. [DOI: 10.3389/fpsyg.2022.960086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
The purpose of the present study was to test the measurement invariance of the baby pediatric symptom checklist (BPSC) across gender and age as a means to provide for valid comparisons in point estimates across groups. A secondary goal involved confirming the earlier identified factor structure and re-examining the presence of differentially item functioning in the BPSC across grouping variables. Participants were 601 children (322 boys and 279 girls) aged below 1 year (n = 294) and 1 year to 12 months (n = 307). Data were collected as part of the National Health Interview Survey in 2020. Results related to gender indicated satisfying all five levels of measurement and structural invariance. When testing measurement invariance across age groups, a few modifications were necessary. Specifically, partial metric invariance was satisfied after freeing slope estimates of items 1 and 2, partial scalar after freeing intercept terms of items 6 and 10, and partial residual invariance through freeing error terms of items 2 and 12. These non-invariant estimates, however, provide support for partial invariance and do not invalidate the comparison of latent means. The BPSC can be used for the valid assessment of social–emotional skills in infants up to the age of 18 months.
Collapse
|
20
|
Schnatschmidt M, Lollies F, Schlarb AA. A single-arm pilot study: can a parental sleep intervention for sleep-disturbed young children in individual settings improve children's sleep, crying, eating, and parental distress in mothers and fathers? BMC Pediatr 2022; 22:578. [PMID: 36207683 PMCID: PMC9541003 DOI: 10.1186/s12887-022-03631-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 09/23/2022] [Indexed: 11/10/2022] Open
Abstract
Background Early sleep problems co-occur with crying, eating problems, and parental distress. This study investigates the impact of a parent-focused intervention to improve child sleep with the following aims: (1) To assess the impact on child sleep (sleep onset latency, frequency and duration of nighttime awakenings, frequency of bed-sharing, and nighttime food intake, total nighttime sleep duration, and sleep efficiency), child crying (frequency of crying episodes, of unexplained and unsoothable crying and of crying out of defiance), child eating difficulties, and parental distress of mothers and fathers. (2) To assess the maintenance of any changes in these areas longitudinally, at 3-month, 6-month, and 12-month follow-ups. (3) To explore at the within-subjects level, how children’s sleep, crying, eating, and parental distress changed together across all study measurement points. Methods In this single-arm pilot study, the parents of 60 children participated in six individual sessions of a parent-focused multimodal age-adjusted cognitive-behavioral intervention to improve child sleep. Parents of 39 children (46% girls, age in months M = 22.41, SD = 12.43) completed pre- and at least one measure after the intervention. Sleep diary, questionnaire for crying, feeding, sleeping, and parental stress index (short-form) were assessed pre, post, three, six, and 12 months after the intervention. Results Significantly, sleep (decreased sleep onset latency, frequency, duration of nighttime awakenings, bed-sharing, nighttime food intake; increased total nighttime sleep duration, sleep efficiency), crying (reduced frequency of crying episodes, unexplained and unsoothable crying), and parental distress (reduced) changed, which remained partially stable over follow-up. The frequency of crying episodes decreased with fewer nighttime awakenings; morning crying with increased nighttime feeding; unexplained and unsoothable crying with higher sleep efficiency; crying due to defiance with more nighttime awakenings, sleep efficiency, and bed-sharing. Eating problems decreased with shorter night awakenings and time; maternal distress with fewer nighttime awakenings, paternal with less child’s nighttime feeding, unexplained and unsoothable crying, and time. Conclusions A parental sleep intervention for sleep-disturbed young children could be promising to reduce children’s sleep problems, crying, eating problems and parental distress. Future studies should consider more personal contact during the follow-up to reduce the drop-out rate and a randomized-controlled design. Trial registration The study was retrospectively registered at the German Clinical Trials Register (ID: DRKS00028578, registration date: 21.03.2022). Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03631-5.
Collapse
Affiliation(s)
- Marisa Schnatschmidt
- Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501, Bielefeld, Germany.
| | - Friederike Lollies
- Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501, Bielefeld, Germany
| | - Angelika A Schlarb
- Faculty of Psychology and Sports Science, Department of Psychology, Clinical Psychology and Psychotherapy of Childhood and Adolescence, Bielefeld University, P.O.P. 10 01 31, DE-33501, Bielefeld, Germany
| |
Collapse
|
21
|
Cave-Freeman D, Mancini VO, Wakschlag LS, Finlay-Jones A. Maternal Emotion Regulation and Early Childhood Irritability: The Role of Child Directed Emotion Regulation Strategies. PERSONALITY AND INDIVIDUAL DIFFERENCES 2022; 196:111717. [PMID: 37206891 PMCID: PMC10193920 DOI: 10.1016/j.paid.2022.111717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Parental assistance with children's emotion regulation (ER) is a form of emotion socialization behavior that has recently been operationalized with the development of the Parent Assistance with Child Emotion Regulation (PACER) questionnaire. In line with Eisenberg et al.'s heuristic model of the socialization of emotion, this study sought to test the links between mothers' ER difficulties, their use of ER strategies with their child, and child irritability - a salient dimension of child regulatory difficulties. Cross-sectional data was collected online with mothers (N = 371) of children aged one month to 5 years (M = 2.07 years, SD = 1.25) and data were analysed using hierarchical multiple regression analysis. After controlling for child age and gender, maternal distress, and household income, we found small but significant associations between maternal ER difficulties and child irritability. However, maternal use of ER strategies did not account for further variance in child irritability. These findings suggest that there are meaningful associations between maternal ER and child irritability, although maternal strategies to support child ER appear independent of their own ER capacity. Whilst not associated with child irritability, maternal support for children's ER may be associated with other indicators of mental health risk and resilience.
Collapse
Affiliation(s)
- Dominique Cave-Freeman
- Early Neurodevelopment and Mental Health Team, Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia
- School of Population Health, Curtin University, Kent St, Bentley, WA 6102, Australia
| | - Vincent O. Mancini
- Early Neurodevelopment and Mental Health Team, Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia
- School of Population Health, Curtin University, Kent St, Bentley, WA 6102, Australia
| | - Lauren S. Wakschlag
- Early Neurodevelopment and Mental Health Team, Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia
- Department of Medical Social Sciences, Feinberg School of Medicine, 625 N. Michigan, Suite 2100, Chicago, IL 60611, United States of America
| | - Amy Finlay-Jones
- Early Neurodevelopment and Mental Health Team, Telethon Kids Institute, 15 Hospital Avenue, Nedlands, WA 6009, Australia
- School of Population Health, Curtin University, Kent St, Bentley, WA 6102, Australia
| |
Collapse
|
22
|
Gustafsson HC, Propper CB. Developmental trajectories of toddler sleep problems: can a person-centered approach help identify children at risk? Sleep 2022; 45:zsac142. [PMID: 35768173 PMCID: PMC9453622 DOI: 10.1093/sleep/zsac142] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 06/15/2022] [Indexed: 08/11/2023] Open
Abstract
STUDY OBJECTIVES Previous research examining toddler sleep problems has relied almost exclusively on variable-centered statistical approaches to analyze these data, which provide helpful information about the development of the average child. The current study examined whether person-centered trajectory analysis, a statistical technique that can identify subgroups of children who differ in their initial level and/or trajectory of sleep problems, has the potential to inform our understanding of toddler sleep problems and their development. METHODS Families (N = 185) were assessed at 12, 24, 30, and 36 months of child age. Latent class growth analysis was used to test for subgroups that differed in their 24-36 month sleep problems. Subgroups were compared on child 36-month externalizing, internalizing, and total problem behaviors, and on 12 month maternal mental health, inter-parental conflict, and maternal parenting behaviors. RESULTS Results support a four-class solution, with "low, stable," "low, increasing," "high, increasing," and "high decreasing" classes. The classes whose sleep problems persisted or worsened over time had worse behavioral problems than those whose symptoms improved or remained stably low. Additionally, 12 month maternal depression and global symptom severity, intimate partner violence, and maternal harsh-intrusive parenting behaviors discriminated between the classes that had similar levels of 24 month sleep disturbance but who had diverging trajectories over time. CONCLUSIONS This statistical approach appears to have the potential to increase understanding of sleep problem trajectories in the early years of life. Maternal mental health, intimate partner violence, and parenting behaviors may be clinically useful markers of risk for the persistence or development of toddler sleep problems.
Collapse
Affiliation(s)
- Hanna C Gustafsson
- Corresponding author. Hanna C. Gustafsson, Oregon Health and Science University, 3181 SW Sam Jackson Park Rd., Multnomah Pavilion, Suite 1400, Mail Code: UHN-80R1, Portland, OR 97239, USA.
| | - Cathi B Propper
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| |
Collapse
|
23
|
Tobarra‐Sanchez E, Riglin L, Agha SS, Stergiakouli E, Thapar A, Langley K. Preschool development, temperament and genetic liability as early markers of childhood ADHD: A cohort study. JCPP ADVANCES 2022; 2:e12099. [PMID: 36478889 PMCID: PMC9716640 DOI: 10.1002/jcv2.12099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 08/01/2022] [Indexed: 11/08/2022] Open
Abstract
Background ADHD is associated with multiple adverse outcomes and early identification is important. The present study sets out to identify early markers and developmental characteristics during the first 30 months of life that are associated with ADHD 6 years later. Methods 9201 participants from the prospective Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort were included. Outcome measures were parent-rated ADHD symptom scores (Strengths and Difficulties Questionnaire, SDQ) and ADHD diagnosis (Development and Wellbeing Assessment, DAWBA) at age 7. Seventeen putative markers were identified from previous literature and included: pre- and peri-natal risk factors, genetic liability (ADHD polygenic risk scores, PRS), early development, temperament scores and regulatory problems. Associations were examined using regression analysis. Results Univariable regression analysis showed that multiple early life factors were associated with future ADHD outcomes, even after controlling for sex and socio-economic status. In a multivariable linear regression model; temperament activity scores (B = 0.107, CI = 0.083-0.132), vocabulary delay (B = 0.605, CI = 0.211-0.988), fine motor delay (B = 0.693, CI = 0.360-1.025) and ADHD PRS (B = 0.184, CI = 0.074-0.294) were associated with future symptoms (R 2 = 10.7%). In a multivariable logistic regression model, ADHD PRS (OR = 1.39, CI = 1.10-1.77) and temperament activity scores (OR = 1.09, CI = 1.04-1.16) showed association with ADHD diagnosis. Conclusion As well as male sex and lower socio-economic status, high temperament activity levels and motor and speech delays in the first 30 months of life, are associated with childhood ADHD. Intriguingly, given that genetic risk scores are known to explain little of the variance of ADHD outcomes, we found that ADHD PRS added useful predictive information. Future research needs to test whether predictive models incorporating aspects of early development and genetic risk scores are useful for predicting ADHD in clinical practice.
Collapse
Affiliation(s)
- Esther Tobarra‐Sanchez
- Child and Adolescent Psychiatry SectionDivision of Psychological Medicine and Clinical Neurosciences and MRC Centre for Neuropsychiatric Genetics and GenomicsSchool of MedicineCardiff UniversityCardiffUK
- Cwm Taf Morgannwg University Health BoardCardiffUK
| | - Lucy Riglin
- Child and Adolescent Psychiatry SectionDivision of Psychological Medicine and Clinical Neurosciences and MRC Centre for Neuropsychiatric Genetics and GenomicsSchool of MedicineCardiff UniversityCardiffUK
| | - Sharifah S. Agha
- Child and Adolescent Psychiatry SectionDivision of Psychological Medicine and Clinical Neurosciences and MRC Centre for Neuropsychiatric Genetics and GenomicsSchool of MedicineCardiff UniversityCardiffUK
- Cwm Taf Morgannwg University Health BoardCardiffUK
| | - Evie Stergiakouli
- MRC Integrative Epidemiology UnitUniversity of BristolBristolUK
- Population Health SciencesBristol Medical SchoolUniversity of BristolBristolUK
| | - Anita Thapar
- Child and Adolescent Psychiatry SectionDivision of Psychological Medicine and Clinical Neurosciences and MRC Centre for Neuropsychiatric Genetics and GenomicsSchool of MedicineCardiff UniversityCardiffUK
| | - Kate Langley
- Child and Adolescent Psychiatry SectionDivision of Psychological Medicine and Clinical Neurosciences and MRC Centre for Neuropsychiatric Genetics and GenomicsSchool of MedicineCardiff UniversityCardiffUK
- School of PsychologyCardiff UniversityCardiffUK
| |
Collapse
|
24
|
Georg AK, Bark C, Wiehmann J, Taubner S. Frühkindliche Regulationsstörungen: Störungsbilder und Behandlungskonzepte. PSYCHOTHERAPEUT 2022. [DOI: 10.1007/s00278-022-00594-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
25
|
Vilar‐Compte M, Pérez‐Escamilla R, Orta‐Aleman D, Cruz‐Villalba V, Segura‐Pérez S, Nyhan K, Richter LM. Impact of baby behaviour on caregiver's infant feeding decisions during the first 6 months of life: A systematic review. MATERNAL & CHILD NUTRITION 2022; 18 Suppl 3:e13345. [PMID: 35363420 PMCID: PMC9113474 DOI: 10.1111/mcn.13345] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/19/2022] [Accepted: 02/21/2022] [Indexed: 01/04/2023]
Abstract
Caregivers are often concerned about baby behaviours. Without adequate counselling, parental response can lead to altering infant feeding and jeopardizing breastfeeding. We conducted a systematic review to assess the evidence about the influence of baby behaviours perceived as problematic (crying, sleep waking and posseting) on infant feeding decisions during the first 6 months of life (self‐reported milk insufficiency, breastfeeding duration and introduction of formula). The review focused on quantitative studies published in English, Portuguese or Spanish without date restriction. The search was designed with the support of a medical librarian and conducted in seven databases. Data were managed in Covidence and risk of bias was assessed through the Johanna Briggs Institute critical appraisal checklists. Synthesis of the literature was guided by a conceptual model of the impact of baby behaviours on caregivers feeding practices. We retrieved and reviewed 4312 titles/abstracts and selected 22 for review; 10 were purely descriptive and 12 were cross‐sectional, prospective and quasi‐experimental studies. Although studies from diverse regions were included in the review, more than half were from high‐income countries. All studies reported that baby behaviours affect feeding decisions, the most common baby behaviours studied were crying and fussiness, and the studies suggested relationships with lactation problems and reports of milk insufficiency, maternal breastfeeding confidence, breastfeeding duration and discontinuation, and introduction of formula. There are many factors that lead to perceiving baby behaviours as problematic and there is a need to provide anticipatory guidance to parents and caregivers, starting in pregnancy and counselling through well‐trained health providers. Although normal infant behaviour is highly variable, caregivers often perceive infant fussing/crying, posseting and sleep to be problematic. How caregivers interpret such ‘problems’ is critical in shaping how they deal with them and the impacts they have on infant feeding practices. Developing baby behaviour is not routinely included in training of health care staff, who often misinterpret baby behaviours and advise changes in feeding strategies. There is a need for large‐scale studies addressing such issues, as well as clearer guidelines for health professionals and caregivers about common baby behaviours and how to cope with them.
Collapse
Affiliation(s)
- Mireya Vilar‐Compte
- Department of Public Health Montclair State University Montclair New Jersey USA
| | - Rafael Pérez‐Escamilla
- Department of Social and Behavioral Sciences Yale School of Public Health New Haven Connecticut USA
| | - Dania Orta‐Aleman
- Human Nutrition Program, Department of International Health Johns Hopkins Bloomberg School of Public Health Baltimore Maryland USA
| | - Valeria Cruz‐Villalba
- Research Institute for Equitable Development Universidad Iberoamericana Mexico City Mexico
| | - Sofía Segura‐Pérez
- Community Nutrition Unit Hispanic Health Council Hartford Connecticut USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library Yale University New Haven Connecticut USA
| | - Linda M. Richter
- DSI‐NRF Centre of Excellence in Human Development, School of Public Health University of the Witwatersrand Johannesburg South Africa
| |
Collapse
|
26
|
Helseth S, Misvær N, Småstuen M, Andenæs R, Valla L. Infant colic, young children's temperament and sleep in a population based longitudinal cohort study. BMC Pediatr 2022; 22:163. [PMID: 35354427 PMCID: PMC8966298 DOI: 10.1186/s12887-022-03231-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Colic and sleep problems are common among infants, constitute challenges and distress for parents, and are often reasons for seeking help from health professionals. The literature debates whether infant colic and sleep problems are linked together or not. Further, limited evidence exists on how colic impacts on child temperament and sleep during early childhood. Thus, the purpose of this study was to increase our knowledge of the characteristics of infants with a history of colic compared to infants without, and to study how infant colic is associated with the development of child temperament and sleep over time. Methods The study is based on The Norwegian Mother, Father and Child Cohort Study (MoBa), a population-based cohort study conducted by the Norwegian Institute of Public Health. This sample contains 88,186 mothers and children. Data was retrieved from questionnaires distributed to mothers at recruitment (in pregnancy) and when the child was 6 months, 18 months, 3 years, and 5 years. Data was analysed using linear mixed models and GLM models for repeated measures. Results At 6 months, infants with reported colic are described as fussier, present more sleeping problems, are breastfed less, and the families visit the child health centre more often when compared to the non-colic group. Mothers of children with reported colic perceive their children’s temperament significantly more challenging from the age of 6 months to 5 years. Further, children with reported colic were more likely to sleep less than recommended (22%) and to have more frequent night awakenings (14%) than usual for their age (6 months to 5 years). Conclusion Infant colic often occurs together with other signs of regulatory problems which may amplify the load on the parents. Moderate differences in temperament and sleep-problems across time, between those with colic and those without, indicate that the diagnosis of colic is moderately associated with later behavioural difficulties. However, it is demanding for the parents, and important to be aware of and act upon symptoms of colic in the child health centres to reduce the parents’ load and prevent adverse long-term outcomes.
Collapse
Affiliation(s)
- Sølvi Helseth
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Nina Misvær
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Milada Småstuen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Randi Andenæs
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Lisbeth Valla
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
27
|
Asmussen J, Skovgaard AM, Bilenberg N. Trajectories of dysregulation in preschool age. Eur Child Adolesc Psychiatry 2022; 31:313-324. [PMID: 33386524 DOI: 10.1007/s00787-020-01689-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 11/18/2020] [Indexed: 02/06/2023]
Abstract
Dysregulation of emotions, behaviour and attention is involved in several areas of childhood psychopathology, but knowledge about early developmental trajectories remains scarce. This study aims to explore continuity and associations of dysregulation in preschool age. Dysregulation was measured at age 2½ years and again at 5 years in a community-based birth cohort of 1099 children using the Child Behavior Checklist, preschool version (CBCL1½-5), answered by mothers. Based on the Dysregulation Profile (CBCL-DP) score, we defined four trajectory groups, using the 75th percentile from the Danish norm material as a cut-off. Associations between the four CBCL-DP trajectory groups and potential covariates, including child, parental and family factors, were analysed using univariate and multiple multinomial logistic regression. Nearly half (54%) of the children showed persistent low scores of CBCL-DP, 17% displayed continuing dysregulation problems, 13% had problems that increased from 2½ years to 5 years, whereas 16% of the children showed reduced problems across preschool age. Persistent dysregulation was associated with maternal postpartum depressive symptoms RRR = 2.20 (95% CI 1.29-3.75), low maternal educational level RRR = 1.69 (95% CI 1.08-2.66), and mothers' smoking during pregnancy RRR = 2.87 (95% CI 1.09-7.55). Persistent problems of emotional, behavioural and attention regulation in children aged 2½ years to 5 years is influenced by maternal educational level and post-partum depression symptoms. The study draws clinical attention to early symptoms of dysregulation and to the importance of addressing the specific needs of mentally vulnerable parents in intervention planning.
Collapse
Affiliation(s)
- Jette Asmussen
- Research Unit of Child and Adolescent Mental Health, Department of Clinical Research, University of Southern Denmark, J.B Winsløws Vej 16, indgang 228, 5000, Odense C, Denmark.
| | - Anne Mette Skovgaard
- Faculty of Health Sciences, National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Niels Bilenberg
- Research Unit of Child and Adolescent Psychiatry Odense, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| |
Collapse
|
28
|
The Infant Health Study - Promoting mental health and healthy weight through sensitive parenting to infants with cognitive, emotional, and regulatory vulnerabilities: protocol for a stepped-wedge cluster-randomized trial and a process evaluation within municipality settings. BMC Public Health 2022; 22:194. [PMID: 35090411 PMCID: PMC8796192 DOI: 10.1186/s12889-022-12551-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 01/07/2022] [Indexed: 11/24/2022] Open
Abstract
Background Child mental health problems are a major public health concern associated with poor mental and physical health later in development. The study evaluates a new community-based intervention to promote sensitive parenting and reduce enduring mental health problems and unhealthy weight among vulnerable infants aged 9-24 months. Methods We use a step-wedge cluster randomized controlled trial design conducted within a home visiting program offered by community health nurses to infant families in Denmark. Sixteen municipalities are randomly allocated to implement the intervention starting at three successive time points from May 1, 2022 to January 1, 2023. A total of 900-1000 families will be included. A standardized program, Psykisk Udvikling og Funktion (PUF), is used to identify infants with major problems of eating, sleep, emotional or behavioral regulation or developmental problems. The intervention builds on the Video-Feedback Intervention to Promote Positive Parenting (VIPP) program, adapted to the PUF-context and named the VIPP-PUF. Children will be followed up at ages 18 and 24 months. Primary outcome measure is the Strengths and Difficulties Questionnaire (SDQ) at child age 24 months. The other outcome measures include body mass index z-scores, the Ages and Stages Questionnaire Social-Emotional (ASQ:SE2); the Child Behavior Checklist (CBCL 1½ -5); Eating behavior Questionnaires; the Being a Mother-questionnaire (BaM13); the Parental Stress Scale (PSS); and the WHO-5 well-being index (WHO-5). Data on child and family factors are obtained from National registries and the Child Health Database. Quantitative measures are applied to examine the effectiveness of the VIPP-PUF intervention and the implementation process. Qualitative measures include interviews with CHNs, parents and municipality stakeholders to explore factors that may influence the adherence and effectiveness of the intervention. Discussion The study examines a service-setting based intervention building on the promotion of sensitive parenting to vulnerable infants. We use a mixed methods approach to evaluate the intervention, taking into account the influences of COVID-19 pandemic running since March 2020. Overall, the study has potential to add to the knowledge on the possibilities of prevention within the municipality child health care to reduce the risk of mental health problems and unhealthy weight in early childhood. Trial registration www.ClinicalTrials.gov; IDNCT04601779; Protocol ID 95-110-21307. Registered 25 June 2021. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12551-z.
Collapse
|
29
|
Perez A, Göbel A, Stuhrmann LY, Schepanski S, Singer D, Bindt C, Mudra S. Born Under COVID-19 Pandemic Conditions: Infant Regulatory Problems and Maternal Mental Health at 7 Months Postpartum. Front Psychol 2022; 12:805543. [PMID: 35153928 PMCID: PMC8826543 DOI: 10.3389/fpsyg.2021.805543] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/09/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The SARS-COVID-19 pandemic and its associated disease control restrictions have in multiple ways affected families with young children, who may be especially vulnerable to mental health problems. Studies report an increase in perinatal parental distress as well as symptoms of anxiety or depression in children during the pandemic. Currently, little is known about the impact of the pandemic on infants and their development. Infant regulatory problems (RPs) have been identified as early indicators of child socio-emotional development, strongly associated with maternal mental health and the early parent-infant interaction. Our study investigates whether early parenthood under COVID-19 is associated with more maternal depressive symptoms and with a perception of their infants as having more RPs regarding crying/fussing, sleeping, or eating, compared to mothers assessed before the pandemic. METHODS As part of a longitudinal study, 65 women who had given birth during the first nationwide disease control restrictions in Northern Germany, were surveyed at 7 months postpartum and compared to 97 women assessed before the pandemic. RPs and on maternal depressive symptoms were assessed by maternal report. Number of previous children, infant negative emotionality, and perceived social support were assessed as control variables. RESULTS Compared to the control cohort, infants born during the COVID-19 pandemic and those of mothers with higher depressive symptoms were perceived as having more sleeping and crying, but not more eating problems. Regression-based analyses showed no additional moderating effect of parenthood under COVID-19 on the association of depressive symptoms with RPs. Infant negative emotionality was positively, and number of previous children was negatively associated with RPs. LIMITATIONS Due to the small sample size and cross-sectional assessment, the possibility for more complex multivariate analysis was limited. The use of parent-report questionnaires to assess infant RPs can support but not replace clinical diagnosis. CONCLUSIONS The pandemic conditions affecting everyday life may have a long-term influence on impaired infant self- and maternal co-regulation and on maternal mental health. This should be addressed in peripartum and pediatric care. Qualitative and longitudinal studies focusing on long-term parental and infant outcomes under ongoing pandemic conditions are encouraged.
Collapse
Affiliation(s)
- Anna Perez
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ariane Göbel
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Lydia Yao Stuhrmann
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steven Schepanski
- Division of Experimental Feto-Maternal Medicine, Department of Obstetrics and Fetal Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Developmental Neurophysiology, Center for Molecular Neurobiology Hamburg (ZMNH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dominique Singer
- Division of Neonatology and Pediatric Intensive Care, Center for Obstetrics and Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Carola Bindt
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
30
|
Ostlund B, Myruski S, Buss K, Pérez-Edgar KE. The centrality of temperament to the research domain criteria (RDoC): The earliest building blocks of psychopathology. Dev Psychopathol 2021; 33:1584-1598. [PMID: 34365985 PMCID: PMC10039756 DOI: 10.1017/s0954579421000511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
The research domain criteria (RDoC) is an innovative approach designed to explore dimensions of human behavior. The aim of this approach is to move beyond the limits of psychiatric categories in the hope of aligning the identification of psychological health and dysfunction with clinical neuroscience. Despite its contributions to adult psychopathology research, RDoC undervalues ontogenetic development, which circumscribes our understanding of the etiologies, trajectories, and maintaining mechanisms of psychopathology risk. In this paper, we argue that integrating temperament research into the RDoC framework will advance our understanding of the mechanistic origins of psychopathology beginning in infancy. In illustrating this approach, we propose the incorporation of core principles of temperament theories into a new "life span considerations" subsection as one option for infusing development into the RDoC matrix. In doing so, researchers and clinicians may ultimately have the tools necessary to support emotional development and reduce a young child's likelihood of psychological dysfunction beginning in the first years of life.
Collapse
Affiliation(s)
- Brendan Ostlund
- Department of Psychology, The Pennsylvania State University, University Park, US
| | - Sarah Myruski
- Department of Psychology, The Pennsylvania State University, University Park, US
| | - Kristin Buss
- Department of Psychology, The Pennsylvania State University, University Park, US
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, US
| | | |
Collapse
|
31
|
Whittall H, Kahn M, Pillion M, Gradisar M. Parents matter: barriers and solutions when implementing behavioural sleep interventions for infant sleep problems. Sleep Med 2021; 84:244-252. [PMID: 34182352 DOI: 10.1016/j.sleep.2021.05.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 05/26/2021] [Accepted: 05/31/2021] [Indexed: 10/21/2022]
Abstract
Behavioural sleep interventions (eg, extinction-based methods) are among the most efficacious evidence-based techniques in the treatment of infant sleep problems. However, behavioural sleep interventions can be challenging for families to successfully implement. This review aims to summarise current research surrounding the potential barriers that arise when clinicians attempt to implement extinction-based methods with parents of infants. We provide a model that summarises 3 types of contextual-barriers; socio-cultural barriers, parent barriers, and infant barriers. Based on the current evidence, we propose that adopting a stepped care approach, planning ahead, increasing support, motivational interviewing, and/or emotional regulation may serve as useful tools for parents when implementing extinction-based methods. By considering these techniques, more families may receive the benefits of improved infant sleep.
Collapse
Affiliation(s)
- Hannah Whittall
- Flinders University, College of Education, Psychology and Social Work, Adelaide, South Australia, Australia.
| | - Michal Kahn
- Flinders University, College of Education, Psychology and Social Work, Adelaide, South Australia, Australia
| | - Meg Pillion
- Flinders University, College of Education, Psychology and Social Work, Adelaide, South Australia, Australia
| | - Michael Gradisar
- Flinders University, College of Education, Psychology and Social Work, Adelaide, South Australia, Australia
| |
Collapse
|
32
|
Cook F, Conway L, Omerovic E, Cahir P, Giallo R, Hiscock H, Mensah F, Bretherton L, Bavin E, Eadie P, Brown S, Reilly S. Infant Regulation: Associations with Child Language Development in a Longitudinal Cohort. J Pediatr 2021; 233:90-97.e2. [PMID: 33549551 DOI: 10.1016/j.jpeds.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 01/31/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To determine whether infants who have regulatory problems (eg, sleeping, crying, and feeding problems) at 1 year of age are at increased risk of experiencing language difficulties at ages 5 and 11 years, compared with settled infants. STUDY DESIGN Parent survey and child assessment data (n = 1131) were drawn from a longitudinal community cohort study. Latent Class Analysis identified 5 profiles of infant regulation including those who were settled (37%), had tantrums (21%), had sleep problems (25%), were moderately unsettled (13%), and severely unsettled (3%) at 12 months of age. Adjusted regression analyses examined associations between infant regulatory profiles and language ability (Clinical Evaluation of Language Fundamentals-fourth edition) at ages 5 and 11 years. RESULTS Infants who were moderately unsettled had lower language scores at age 5 (adjusted mean difference, -3.89; 95% CI, -6.92 to -0.86) and were more likely to have language difficulties (aOR, 2.71; 95% CI, 1.28-5.75), than infants who were settled. Infants who were severely unsettled at 12 months of age, had lower language scores at ages 5 (adjusted mean difference, -7.71; 95% CI, -13.07 to -2.36) and 11 (adjusted mean difference, -6.50; 95% CI, -11.60 to -1.39), than infants who were settled. Severely unsettled infants were 5 times more likely to have language difficulties at age 5 than their settled counterparts (aOR, 5.01; 95% CI, 1.72-14.63). CONCLUSIONS Children at 1 year of age with multiple regulatory problems are at an increased risk for poorer language skills at ages 5 and 11 years.
Collapse
Affiliation(s)
- Fallon Cook
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia.
| | - Laura Conway
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Emina Omerovic
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Petrea Cahir
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Rebecca Giallo
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Harriet Hiscock
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia
| | - Fiona Mensah
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Royal Children's Hospital, Melbourne, Australia
| | - Lesley Bretherton
- Murdoch Children's Research Institute, Melbourne, Australia; La Trobe University, Melbourne, Australia
| | - Edith Bavin
- Murdoch Children's Research Institute, Melbourne, Australia; La Trobe University, Melbourne, Australia
| | - Patricia Eadie
- Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia
| | - Stephanie Brown
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of General Practice, University of Melbourne, Melbourne, Australia
| | - Sheena Reilly
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| |
Collapse
|
33
|
Schmidt SJ, Barblan LP, Lory I, Landolt MA. Age-related effects of the COVID-19 pandemic on mental health of children and adolescents. Eur J Psychotraumatol 2021; 12:1901407. [PMID: 33968328 PMCID: PMC8075089 DOI: 10.1080/20008198.2021.1901407] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Background: Children and adolescents are affected in various ways by the lockdown measures due to the COVID-19 pandemic. Therefore, it is crucial to better understand the effects of the COVID-19 pandemic on mental health in this age-group. Objective: The objective was to investigate and compare the effects of the COVID-19 pandemic on mental health in three age groups (1-6 years, 7-10 years, 11-19 years) and to examine the associations with psychological factors. Methods: An anonymous online survey was conducted from 9 April to 11 May 2020 during the acute phase of major lockdown measures. In this cross-sectional study, children and adolescents aged between 1 and 19 years were recruited as a population-based sample. They were eligible if they were residents in Austria, Germany, Liechtenstein or Switzerland, were parents/caregivers of a child aged between 1 and 10 years or adolescents ≥11 years, had sufficient German language skills and provided informed consent. Results: Among 5823 participants, between 2.2% and 9.9% reported emotional and behavioural problems above the clinical cut-off and between 15.3% and 43.0% reported an increase in these problems during the pandemic. Significant age-related effects were found regarding the type and frequency of problems (χ2 (4)≥50.2, P ≤ 0.001). While preschoolers (1-6 years) had the largest increase in oppositional-defiant behaviours, adolescents reported the largest increase in emotional problems. Adolescents experienced a significantly larger decrease in emotional and behavioural problems than both preschoolers and school-children. Sociodemographic variables, exposure to and appraisal of COVID-19, psychotherapy before COVID-19 and parental mental health significantly predicted change in problem-scores (F ≥ 3.69, P ≤ 0.001). Conclusion: A substantial proportion of children and adolescents experience age-related mental health problems during the COVID-19 pandemic. These problems should be monitored, and support should be offered to risk-groups to improve communication, emotion regulation and appraisal style.
Collapse
Affiliation(s)
- Stefanie J Schmidt
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Lara P Barblan
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Irina Lory
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Markus A Landolt
- Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland.,Department of Psychosomatics and Psychiatry, And Children's Research Centre, University Children's Hospital Zurich, Zurich, Switzerland
| |
Collapse
|
34
|
Jacob P, Ts J, G SK, L M, Gr G, K T, Srinath S. Behavioural, emotional and rhythm-related disturbances in toddlers: Preliminary findings from a community-based study in Kerala, India. Infant Ment Health J 2021; 42:292-298. [PMID: 33394552 DOI: 10.1002/imhj.21905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The need to enhance mental health in primary care settings for infants and toddlers is increasingly becoming apparent. However, the lack of trained healthcare personnel and culturally appropriate measures makes it a challenge in low- and middle-income countries. A needs-based assessment of the extent of the problems in toddlers will help address the lacunae in providing mental health services. METHODS A needs-based assessment was carried out of a community sample of 9,287 mothers with toddlers aged between 13 and 25 months in Kerala, India. This assessment was conducted by junior public health nurses using an indigenously developed checklist titled 'Screening checklist for Behavioural, Emotional and Rhythm-related disturbances in Toddlers' (S-BERT). RESULTS According to the mothers surveyed, 30.4% of toddlers had concerning or distress causing behaviours. Three factors, namely behavioural, rhythm-related and emotional disturbances, were deemed significant when the item response theory was used to examine the factor structure of S-BERT. CONCLUSION This study suggests that behaviours that cause distress to mothers of toddlers are common, if queried specifically. Given the constraints in health resources as the cultural factors in operation, use of indigenous tools and principles of collaborative stepped care may be the way forward.
Collapse
Affiliation(s)
- Preeti Jacob
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Jaisoorya Ts
- Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | | | - Manoj L
- National Health Mission, Kerala, India
| | - Gokul Gr
- National Health Mission, Kerala, India
| | - Thennarasu K
- Department of Biostatistics, National Institute of Mental Health and Neurosciences, Bengaluru, India
| | - Shoba Srinath
- Department of Child and Adolescent Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, India
| |
Collapse
|
35
|
Schnatschmidt M, Cattarius B, Schneider B, Jud A, Schlarb AA. Wie ist die Lage in Einrichtungen für frühkindliche Regulationsstörungen in Deutschland? ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2021. [DOI: 10.1026/1616-3443/a000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: Frühkindliche Regulationsprobleme stehen in Verbindung mit Schlafproblemen und unsicherem Elternverhalten. Störungsspezifische Behandlungsansätze sind vielfältig und unterscheiden sich deutlich hinsichtlich Qualität und Evidenzgrad. Fragestellung: Häufigkeiten von Schlafproblemen, elterliche Unsicherheiten, therapeutisch / beraterische Grundorientierungen und Konzepte werden erfasst und Unterschiede zwischen Einrichtungsarten untersucht. Methode: Die Umfrage wurde mit interdisziplinären Experten entwickelt. Eine deutschlandweite Datenbank (622 Einrichtungen) mit einer finalen Stichprobe von N = 160 wurde erstellt. Ergebnisse: Schlafprobleme gelten als häufigster Anmeldegrund (59 %), unsicheres Erziehungsverhalten als mehrheitlich relevant (66 %). Über 16 Behandlungskonzepte werden angewandt; je nach Einrichtungsart eher systemische ( d = 0.5), körperorientierte ( d = 0.5) oder somatisch-medizinische ( d = 0.7) Verfahren. Schlussfolgerung: Die schlafspezifische Expertise der Fachkräfte sollte gesichert sowie Transparenz und Überprüfbarkeit von Qualitätsstandards weiterentwickelt werden.
Collapse
Affiliation(s)
- Marisa Schnatschmidt
- Fakultät für Psychologie und Sportwissenschaft, Abteilung für Psychologie, Universität Bielefeld
| | - Barbara Cattarius
- Fakultät für Psychologie und Sportwissenschaft, Abteilung für Psychologie, Universität Bielefeld
| | - Barbara Schneider
- Zentrum für Neuropädiatrie und Schlafmedizin, Kinderkrankenhaus St. Marien, Landshut
| | - Andreas Jud
- Kinder- und Jugendpsychiatrie / Psychotherapie, Universitätsklinikum Ulm
- Soziale Arbeit, Hochschule Luzern, Luzern, Schweiz
| | - Angelika A. Schlarb
- Fakultät für Psychologie und Sportwissenschaft, Abteilung für Psychologie, Universität Bielefeld
| |
Collapse
|
36
|
Holdø I, Bramness JG, Handal M, Hansen BH, Hjellvik V, Skurtveit S. Association Between Prescribed Hypnotics in Infants and Toddlers and Later ADHD: A Large Cohort Study from Norway. Child Psychiatry Hum Dev 2021; 52:533-543. [PMID: 32772207 PMCID: PMC8238762 DOI: 10.1007/s10578-020-01039-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
As previously indicated an association may exist between early sleep problems in infants and toddlers, and a diagnosis of attention deficit hyperactivity disorder (ADHD). The aim of this study was to study if this association could be replicated in a complete nationwide cohort of children. Prospective cohort study using national registries. All children born in Norway from January 2004 to December 2010 were included (N = 410,555). Information on hypnotic drugs dispensed to children 0-3 years of age outside of institutions was collected from the Norwegian Prescription Database and used as a proxy for sleep problems. The outcome ADHD (ICD-10), as diagnosed by specialists in the Child Mental Health Service, was obtained from the Norwegian Patient Registry. Data were analysed using weighted estimation in Cox regression. The unadjusted weighted hazard ratio (wHR) for a later diagnosis of ADHD in children dispensed two or more prescriptions for any hypnotic drug, compared to zero prescriptions, was 2.30 [95% confidence interval (CI) 1.63-3.23] for girls and 1.75 (95% CI 1.48-2.07) for boys. For the sedative antihistamine trimeprazine the corresponding wHR was 3.71 (95% CI 1.83-7.52) for girls and 2.78 (95% CI 2.04-3.80) for boys. After adjusting for parental ADHD and parental education the wHR for trimeprazine users was 2.81 (95% CI 1.34-5.88) for girls and 2.33 (95% CI 1.70-3.20) for boys. Infants and toddlers who were dispensed hypnotics had an increased risk of ADHD at school age. This association was most pronounced with the use of trimeprazine, a drug traditionally prescribed to toddlers for sleep problems in Norway. After adjusting for parental ADHD and educational level the risk for ADHD among the trimeprazine users was still more than twice the risk among controls.
Collapse
Affiliation(s)
- Ingvild Holdø
- Norwegian Centre of Addiction Research, University of Oslo, Oslo, Norway
| | - Jørgen G. Bramness
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Hamar, Norway ,Institute of Clinical Medicine, UiT – Norway’s Arctic University, Tromsö, Norway ,Norwegian Institute of Public Health, Skøyen, P.O. Box 222, 0213 Oslo, Norway
| | - Marte Handal
- Norwegian Institute of Public Health, Skøyen, P.O. Box 222, 0213 Oslo, Norway
| | - Berit Hjelde Hansen
- Norwegian Center on Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo, Norway
| | - Vidar Hjellvik
- Norwegian Institute of Public Health, Skøyen, P.O. Box 222, 0213 Oslo, Norway
| | - Svetlana Skurtveit
- Norwegian Centre of Addiction Research, University of Oslo, Oslo, Norway ,Norwegian Institute of Public Health, Skøyen, P.O. Box 222, 0213 Oslo, Norway
| |
Collapse
|
37
|
Shan H, Li F, Zhang J, Wang H, Li J. Feeding and Eating Disorder and Risk of Subsequent Neurodevelopmental Disorders: A Population-Based Cohort Study. Front Pediatr 2021; 9:671631. [PMID: 34552897 PMCID: PMC8451269 DOI: 10.3389/fped.2021.671631] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/03/2021] [Indexed: 11/30/2022] Open
Abstract
Background: There are limited data concerning the long-term mental health of children with feeding and eating disorder (FED). We aimed to investigate whether children with FED are at greater risks of developing emotional/behavioral disorders with onset usually during childhood, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID). Methods: We conducted a population-based cohort study, including all singleton births in Denmark from January 1, 1995, to December 31, 2015. For each child diagnosed with FED, 10 age- and sex-matched controls who did not meet the criteria for FED were randomly selected from the general population. Associations were estimated with Cox regression modes adjusting for other perinatal and maternal factors, and sibling analyses were performed for controlling potential confounding by shared familial (genetic or environmental) factors. Results: Of the 1,256,989 individuals in the cohort, there were 1967 (53.4% girls) children diagnosed with FED. Children with FED had higher risks for clinically diagnosed emotional/behavioral disorders with onset usually in childhood (hazard ratio [HR], 2.78; 95% CI, 2.34-3.31), ADHD (HR, 1.74; 95% CI, 1.33-2.26), ASD (HR, 3.05; 95% CI, 2.36-3.94), and ID (HR, 6.38; 95% CI, 4.48-9.11), compared with matched controls. Girls with FED are at greater risks for emotional/behavioral disorders and ID, but not ADHD and ASD. Alike, in sibling analysis, increased rates are also observed for other neurodevelopmental disorders, but not for ADHD. Conclusion: Children with FED are associated with substantially increased risks of emotional/behavioral disorders, ADHD, ASD, and ID. This study highlights the importance of carefully monitoring neurodevelopmental disorders in children with FED.
Collapse
Affiliation(s)
- Hongyun Shan
- Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Fei Li
- Department of Developmental and Behavioral Pediatric & Child Primary Care, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hui Wang
- Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiong Li
- Ministry of Education -Shanghai Key Laboratory of Children's Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| |
Collapse
|
38
|
Adams EL, Master L, Buxton OM, Savage JS. Patterns of infant-only wake bouts and night feeds during early infancy: An exploratory study using actigraphy in mother-father-infant triads. Pediatr Obes 2020; 15:e12640. [PMID: 32319729 DOI: 10.1111/ijpo.12640] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Infants' ability to fall back to sleep without parental involvement may reduce nighttime feeding frequency. OBJECTIVE We describe the associations between infant-only wake bouts ("self-soothing") and nighttime feeds using actigraphy from 6 to 24 weeks of age. METHODS Mother-father-infant triads (N = 20) wore sleep monitors, and mothers recorded infant night feeds, when infants were 6, 15 and 24 weeks of age. Actigraphy data were matched within-families to quantify infant-only wake bouts (infants woke; mothers/fathers remained asleep). Mixed models tested associations between infant-only wake bouts and night feeding frequency. RESULTS The proportion of infant-only wake bouts/night increased from 6 to 15 weeks of age (6 weeks: 52% [95% CI: 45-59]; 15 weeks: 64% [57-71]; 24 weeks: 62% [55-69]; P < .01). For every 10% increase in the proportion of infant-only wake bouts/night, there were 0.36 fewer feeds/night (P < .01) at 24 weeks; these concurrent associations were not found at 6 and 15 weeks. The proportion of infant-only wake bouts/night at 6 weeks predicted a faster rate of decline in the number of feeds/night from 6 to 24 weeks (P < .01). CONCLUSION Infants' ability to fall back to sleep without parent involvement at 6 weeks was associated with the trajectory of nighttime feeding frequency across early infancy.
Collapse
Affiliation(s)
- Elizabeth L Adams
- Department of Nutritional Sciences, Center for Childhood Obesity Research, Penn State University, Pennsylvania, USA.,Department of Nutrition Sciences, Penn State University, Pennsylvania, USA
| | - Lindsay Master
- Department of Biobehavioral Health, The Pennsylvania State University, Pennsylvania, USA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, The Pennsylvania State University, Pennsylvania, USA
| | - Jennifer S Savage
- Department of Nutritional Sciences, Center for Childhood Obesity Research, Penn State University, Pennsylvania, USA.,Department of Nutrition Sciences, Penn State University, Pennsylvania, USA
| |
Collapse
|
39
|
Camacho MC, King LS, Ojha A, Garcia CM, Sisk LM, Cichocki AC, Humphreys KL, Gotlib IH. Cerebral blood flow in 5- to 8-month-olds: Regional tissue maturity is associated with infant affect. Dev Sci 2020; 23:e12928. [PMID: 31802580 PMCID: PMC8931704 DOI: 10.1111/desc.12928] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 11/20/2019] [Accepted: 12/02/2019] [Indexed: 12/12/2022]
Abstract
Infancy is marked by rapid neural and emotional development. The relation between brain function and emotion in infancy, however, is not well understood. Methods for measuring brain function predominantly rely on the BOLD signal; however, interpretation of the BOLD signal in infancy is challenging because the neuronal-hemodynamic relation is immature. Regional cerebral blood flow (rCBF) provides a context for the infant BOLD signal and can yield insight into the developmental maturity of brain regions that may support affective behaviors. This study aims to elucidate the relations among rCBF, age, and emotion in infancy. One hundred and seven mothers reported their infants' (infant age M ± SD = 6.14 ± 0.51 months) temperament. A subsample of infants completed MRI scans, 38 of whom produced usable perfusion MRI during natural sleep to quantify rCBF. Mother-infant dyads completed the repeated Still-Face Paradigm, from which infant affect reactivity and recovery to stress were quantified. We tested associations of infant age at scan, temperament factor scores, and observed affect reactivity and recovery with voxel-wise rCBF. Infant age was positively associated with CBF in nearly all voxels, with peaks located in sensory cortices and the ventral prefrontal cortex, supporting the formulation that rCBF is an indicator of tissue maturity. Temperamental Negative Affect and recovery of positive affect following a stressor were positively associated with rCBF in several cortical and subcortical limbic regions, including the orbitofrontal cortex and inferior frontal gyrus. This finding yields insight into the nature of affective neurodevelopment during infancy. Specifically, infants with relatively increased prefrontal cortex maturity may evidence a disposition toward greater negative affect and negative reactivity in their daily lives yet show better recovery of positive affect following a social stressor.
Collapse
Affiliation(s)
| | | | - Amar Ojha
- Stanford University, Stanford, CA, USA
| | | | | | | | | | | |
Collapse
|
40
|
Bergström M, Gebreslassie M, Hedqvist M, Lindberg L, Sarkadi A, Hjern A. Narrative review of interventions suitable for well-baby clinics to promote infant attachment security and parents' sensitivity. Acta Paediatr 2020; 109:1745-1757. [PMID: 32027407 DOI: 10.1111/apa.15212] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/31/2020] [Accepted: 02/03/2020] [Indexed: 11/27/2022]
Abstract
AIM The aim of this narrative review was to evaluate the evidence for interventions for children's secure attachment relationships and parents' caregiving sensitivity that could potentially be implemented in the context of a well-baby clinic. METHODS Literature search on programmes for parental caregiving sensitivity and secure attachment for infants aged 0-24 months. Randomised controlled trials (RCTs) published 1995-2018 with interventions starting from one week postpartum, and with a maximum of 12 sessions (plus potential booster session) were included. RESULTS We identified 25 studies, of which 22 studied effects of home-based programmes using video feedback techniques. Positive effects of these interventions in families at risk were found on parental caregiving sensitivity and to a lesser extent also on children's secure or disorganised attachment. The effects of two of these programmes were supported by several RCTs. Three intervention studies based on group and individual psychotherapy showed no significant positive effects. Most of the interventions targeted mothers only. CONCLUSION The review found some evidence for positive effects of selective interventions with video feedback techniques for children's secure attachment and strong evidence for positive effects on parental caregiving sensitivity. Important knowledge gaps were identified for universal interventions and interventions for fathers and parents with a non-Western background.
Collapse
Affiliation(s)
- Malin Bergström
- Sachs’ Children and Youth Hospital Stockholm Sweden
- Department of Medicine Clinical Epidemiology Unit Karolinska Institutet Stockholm Sweden
- CHESS Centre for Health Equity Studies Stockholm University and Karolinska Institutet Stockholm Sweden
| | | | - Maria Hedqvist
- Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden
| | - Lene Lindberg
- Department of Global Public Health Karolinska Institutet & Center for Epidemiology and Community Medicine Stockholm Sweden
| | - Anna Sarkadi
- Department of Public Health and Caring Sciences Uppsala University Uppsala Sweden
| | - Anders Hjern
- Sachs’ Children and Youth Hospital Stockholm Sweden
- Department of Medicine Clinical Epidemiology Unit Karolinska Institutet Stockholm Sweden
- CHESS Centre for Health Equity Studies Stockholm University and Karolinska Institutet Stockholm Sweden
| |
Collapse
|
41
|
Baumann N, Jaekel J, Breeman L, Bartmann P, Bäuml JG, Avram M, Sorg C, Wolke D. The association of infant crying, feeding, and sleeping problems and inhibitory control with attention regulation at school age. INFANCY 2020; 24:768-786. [PMID: 32677276 DOI: 10.1111/infa.12305] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 04/08/2019] [Accepted: 05/18/2019] [Indexed: 12/24/2022]
Abstract
Regulatory problems in infancy and toddlerhood have previously been associated with an increased risk of developing attention problems in childhood. We hypothesized that early regulatory problems are associated with attention problems via reduced inhibitory control. This prospective study assessed 1,459 children from birth to 8 years. Crying, feeding, and sleeping problems were assessed at 5 and 20 months via parent interviews and neurological examinations. At 20 months, inhibitory control was tested with a behavioral (snack delay) task. Attention regulation was assessed at 6 and 8 years using multiple instruments and informants. Detrimental effects of crying, feeding, and sleeping problems on attention regulation were partly mediated by children's ability to inhibit unwanted behaviors (β = -0.04, p = 0.013). Accounting for cognition diminished this indirect effect (β = -0.01, p = 0.209). Instead, the effects of crying, feeding, and sleeping problems on attention regulation were fully mediated by children's cognitive functioning (β = -0.10, p < 0.001). These results support that inhibitory control abilities partly mediate effects of crying, feeding, and sleeping problems. However, these effects may be accounted for by children's general cognitive abilities. Early regulatory problems may set infants on a course of under control of behavior into school age, and such trajectories are highly associated with general cognitive development.
Collapse
Affiliation(s)
- Nicole Baumann
- Department of Psychology, University of Warwick, Coventry, UK
| | - Julia Jaekel
- Department of Psychology, University of Warwick, Coventry, UK.,Department of Child and Family Studies, University of Tennessee, Knoxville, Tennessee
| | - Linda Breeman
- Department of Psychology, University of Warwick, Coventry, UK.,Department of Youth and Family, Utrecht University, Utrecht, The Netherlands.,Department of Neuroradiology, Technische Universität München, München, Germany
| | - Peter Bartmann
- Department of Neonatology, University Hospital Bonn, Bonn, Germany
| | - Josef G Bäuml
- Department of Neuroradiology, Technische Universität München, München, Germany.,TUM-NIC Neuroimaging Center, Technische Universität München, München, Germany
| | - Mihai Avram
- Department of Neuroradiology, Technische Universität München, München, Germany.,TUM-NIC Neuroimaging Center, Technische Universität München, München, Germany
| | - Christian Sorg
- Department of Neuroradiology, Technische Universität München, München, Germany.,TUM-NIC Neuroimaging Center, Technische Universität München, München, Germany.,Department of Psychiatry, Klinikum rechts der Isar, Technische Universität München, München, Germany
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK.,Warwick Medical School, University of Warwick, Coventry, UK
| |
Collapse
|
42
|
Emotional-Behavioral Functioning, Maternal Psychopathologic Risk and Quality of Mother-Child Feeding Interactions in Children with Avoidant/Restrictive Food Intake Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17113811. [PMID: 32471208 PMCID: PMC7311983 DOI: 10.3390/ijerph17113811] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/19/2020] [Accepted: 05/26/2020] [Indexed: 12/15/2022]
Abstract
The literature on food intake disorder (ARFID) in early childhood has evidenced psychopathologic difficulties in both children and their mothers and a poor quality of feeding interactions. Only a few studies have focused on three different ARFID subtypes: irritable/impulsive (I/I), sensory food aversions (SFA) and post traumatic feeding disorder (PTFD). The aim of this study was to explore possible differences between the three groups in children’s emotional-behavioral functioning, maternal psychopathologic risk and the quality of mother–child feeding interactions, comparing these clinical groups with a control group. The sample consisted of 100 child–mother dyads, of which 23 children with I/I, 25 children with SFA, 27 children with PTFD and 27 children with no diagnosis. The mothers primarily filled out questionnaires assessing their psychopathologic symptoms and children’s emotional-behavioral functioning. Then, all dyads were videotaped during a main meal. Results revealed significant differences between the study groups in relation to children’s emotional–adaptive functioning, mothers’ psychological profile and mother–child interactions during feeding. These findings are relevant for the development of target intervention programs to treat specific ARFID disorders.
Collapse
|
43
|
Skuladottir A, Sigurdardottir AO, Svavarsdottir EK. The better sleep better well-being programme: Educating and training community healthcare nurses in developing interventions for families of infants with moderate sleep problems: a pilot study. Scand J Caring Sci 2020; 35:268-276. [PMID: 32240544 DOI: 10.1111/scs.12844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 03/09/2020] [Indexed: 11/30/2022]
Abstract
The main aim of this pilot study was to evaluate the benefit of the Better Sleep Better Well-being (BSBW) educational and training intervention programme regarding infants sleep problems for Community Health Care (CHC) nurses, on their perceptions on their family nursing practice skills and on their job demand, control and support. There were 6 CHC nurses who participated in the BSBW programme, and 26 nurses in the comparison group. The programme consisted of 4 sessions (8 hours per session) of lectures on the aetiology of infants sleep problems as well as on evidence-based and family relational practices and on 20 sessions of clinical cases, scenarios, discussions and reflections. The main finding indicated that the nurses in the intervention group reported significantly higher family nursing practices skills compared to the nurses in the comparison group. The findings are promising, since they offered additional resources to the CHC nurses, in their clinical practices.
Collapse
|
44
|
Hash JB, Oxford ML, Ward TM, Fleming CB, Spieker SJ. Sleep Patterns, Problems and Ecology among Toddlers in Families with a Child Protective Services Maltreatment Referral. J Pediatr Nurs 2020; 51:85-91. [PMID: 31945664 PMCID: PMC7276301 DOI: 10.1016/j.pedn.2019.12.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 10/20/2019] [Accepted: 12/22/2019] [Indexed: 12/12/2022]
Abstract
PURPOSE To describe sleep patterns, problems, and ecology among toddlers (13 to 36 months) from families referred to Child Protective Services (CPS) for maltreatment and to compare sleep duration among a subgroup (24- to 36-month-olds) to previously published population-based data. DESIGN AND METHODS A secondary analysis of a larger longitudinal study was conducted. Participants included 113 parent-toddler dyads recruited out of CPS offices based on having a recent maltreatment referral. Parents reported about their toddler's sleep at two time points (approximately six months apart). RESULTS At the earlier and later time points, respectively, mean sleep duration was 11.03 and 10.90 h (nighttime), 1.36 and 1.36 h (daytime), and 12.47 and 12.28 h (total 24-h). Of the toddlers, 24% and 17% had two or more nighttime awakenings, 34% and 33% had at least a somewhat hard time falling asleep, and 25% and 26% had difficulty sleeping alone. Mean bedtimes were 8:50 pm and 8:58 pm. Nighttime sleeping arrangement/location, nap arrangement/location, and method of falling asleep at night varied. Compared to the population-based data, nighttime sleep duration was 43 min longer and nap duration was 46 min shorter in the CPS sample. CONCLUSIONS Symptoms of behavioral sleep problems were common in this sample of toddlers from families referred to CPS for maltreatment. Distribution of sleep, but not total 24-hour sleep, differed significantly between the CPS sample and the population-based data. PRACTICE IMPLICATIONS Nurses caring for toddlers from families involved with CPS can play an integral role promoting sleep health and addressing behavioral sleep problems.
Collapse
Affiliation(s)
- Jonika B Hash
- Department of Biobehavioral Nursing & Health Informatics, University of Washington, Seattle, WA, United States of America.
| | - Monica L Oxford
- Department of Family & Child Nursing, University of Washington, Seattle, WA, United States of America
| | - Teresa M Ward
- Psychosocial & Community Health, University of Washington, Seattle, WA, United States of America
| | - Charles B Fleming
- Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, United States of America
| | - Susan J Spieker
- Department of Family & Child Nursing, University of Washington, Seattle, WA, United States of America
| |
Collapse
|
45
|
Winsper C, Bilgin A, Wolke D. Associations between infant and toddler regulatory problems, childhood co-developing internalising and externalising trajectories, and adolescent depression, psychotic and borderline personality disorder symptoms. J Child Psychol Psychiatry 2020; 61:182-194. [PMID: 31469175 DOI: 10.1111/jcpp.13125] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/12/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Early regulatory problems (RPs) are associated with childhood internalising and externalising symptoms. Internalising and externalising symptoms, in turn, are associated with adolescent psychopathology (e.g. personality disorders, depression). We examined whether RPs are directly associated with adolescent psychopathology, or whether associations are indirect via childhood internalising and externalising symptoms. METHODS We used data from the Avon Longitudinal Study of Parents and Children. Mothers reported on their child's RPs at 6, 15-18 and 24-30 months, and internalising and externalising symptoms at 4, 7, 8 and 9.5 years. Adolescent psychotic, depression and BPD symptoms were assessed at 11-12 years. Children were grouped by their patterns of co-developing internalising and externalising symptoms using parallel process latent class growth analysis (PP-LCGA). Path analysis was used to examine direct and indirect associations from RPs to the three adolescent outcomes. RESULTS There were four groups of children with distinct patterns of co-developing internalising and externalising (INT/EXT) symptoms. Most children (53%) demonstrated low-moderate and stable levels of INT/EXT symptoms. A small proportion (7.7%) evidenced moderate and increasing INT and high stable EXT symptoms: this pattern was strongly predictive of adolescent psychopathology (e.g. depression at 11 years: unadjusted odds ratio = 5.62; 95% confidence intervals = 3.82, 8.27). The other two groups were differentially associated with adolescent outcomes (i.e. moderate-high increasing INT/moderate decreasing EXT predicted mother-reported depression at 12, while low stable INT/moderate-high stable EXT predicted child-reported depression at 11). In path analysis, RPs at each time-point were significantly indirectly associated with symptoms of BPD and child- and mother-reported depression symptoms via the most severe class of INT/EXT symptoms. CONCLUSIONS Consistent with a cascade model of development, RPs are predictive of higher levels of co-developing INT/EXT symptoms, which in turn increase risk of adolescent psychopathology. Clinicians should be aware of, and treat, early RPs to prevent chronic psychopathology.
Collapse
Affiliation(s)
- Catherine Winsper
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.,R & I Department, Caludon Centre, Coventry and Warwickshire Partnership Trust, Coventry, UK
| | - Ayten Bilgin
- Department of Psychology, University of Warwick, Coventry, UK.,Berlin Psychological University, Berlin, Germany
| | - Dieter Wolke
- Division of Mental Health and Wellbeing, Warwick Medical School, University of Warwick, Coventry, UK.,Department of Psychology, University of Warwick, Coventry, UK
| |
Collapse
|
46
|
Deutz MHF, Geeraerts SB, Belsky J, Deković M, van Baar AL, Prinzie P, Patalay P. General Psychopathology and Dysregulation Profile in a Longitudinal Community Sample: Stability, Antecedents and Outcomes. Child Psychiatry Hum Dev 2020; 51:114-126. [PMID: 31359330 DOI: 10.1007/s10578-019-00916-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The general factor of psychopathology (GP, or p factor) and the Dysregulation Profile (DP) are two conceptually similar, but independently developed approaches to understand psychopathology. GP and DP models and their stability, antecedents and outcomes are studied in a longitudinal sample of 1073 children (49.8% female). GP and DP models were estimated at ages 8 and 14 years using the parent-reported Child Behavior Checklist (CBCL) and Youth Self Report (YSR). Early childhood antecedents and adolescent outcomes were derived using a multi-method multi-informant approach. Results showed that the general GP and DP had similar key symptoms and were similarly related to early-childhood antecedents (e.g., lower effortful control, higher maternal depression) and adolescent outcomes (e.g., reduced academic functioning, poorer mental health). This study demonstrates that GP and DP are highly similar constructs in middle childhood and adolescence, both describing a general vulnerability for psychopathology with (emotional) dysregulation at its core. Scientific integration of these approaches could lead to a better understanding of the structure, antecedents and outcomes of psychopathology.
Collapse
Affiliation(s)
- Marike H F Deutz
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands. .,Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands.
| | - Sanne B Geeraerts
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
| | - Jay Belsky
- University of California, Davis, CA, USA
| | - Maja Deković
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
| | - Anneloes L van Baar
- Department of Child and Adolescent Studies, Utrecht University, Utrecht, The Netherlands
| | - Peter Prinzie
- Department of Psychology, Education & Child Studies, Erasmus University Rotterdam, PO Box 1738, 3000 DR, Rotterdam, The Netherlands
| | | |
Collapse
|
47
|
Duh-Leong C, Jo Messito M, Katzow MW, Tomopoulos S, Nagpal N, Fierman AH, Gross RS. Material Hardships and Infant and Toddler Sleep Duration in Low-Income Hispanic Families. Acad Pediatr 2020; 20:1184-1191. [PMID: 32650047 PMCID: PMC9286002 DOI: 10.1016/j.acap.2020.07.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 06/29/2020] [Accepted: 07/01/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To assess relationships between material hardships, shortened sleep duration, and suboptimal sleep practices across infancy and toddlerhood in low-income Hispanic families. METHODS We analyzed longitudinal data of 451 low-income Hispanic mother-child pairs from a child obesity prevention trial. During infancy and toddlerhood, we used adjusted linear regression to assess associations between material hardship (financial difficulty, food insecurity, housing disrepair, and multiple hardships), sleep duration (24-hour, night), and the number of suboptimal sleep practices (eg, later bedtime, co-sleeping). We used adjusted linear regression to assess the longitudinal association between the number of suboptimal sleep practices in infancy and toddlerhood, and tested whether specific or multiple hardships moderated this association. RESULTS In infants, financial difficulty and multiple hardships were associated with decreased night sleep (B = -0.59 hours, 95% confidence interval [CI]: -1.04, -0.14; and B = -0.54 hours, 95% CI: -1.00, -0.08). Housing disrepair was associated with decreased 24-hour sleep (B = -0.64 hours, 95% CI: -1.29, -0.01). In toddlers, each additional suboptimal sleep practice was associated with a decrease in night sleep (B = -0.19 hours, 95% CI: -0.29, -0.09). Each additional suboptimal sleep practice in infancy was associated with a 0.30 increase in the number of suboptimal sleep practices in toddlerhood (P < .001), with greater increases for those with food insecurity or multiple hardships. CONCLUSION Specific and multiple hardships shortened sleep duration during infancy, and moderated the increase of suboptimal sleep behaviors between infancy and toddlerhood. Future studies should consider these early critically sensitive periods for interventions to mitigate material hardships and establish healthy sleep practices.
Collapse
Affiliation(s)
- Carol Duh-Leong
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine (C Duh-Leong, MJ Messito, S Tomopoulos, N Nagpal, AH Fierman, and RS Gross).
| | - Mary Jo Messito
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Michelle W. Katzow
- Division of General Pediatrics, Department of Pediatrics, Zucker School of Medicine at, Hofstra/Northwell, 269-01 76th Ave, New Hyde Park, NY 11040 USA
| | - Suzy Tomopoulos
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Nikita Nagpal
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Arthur H. Fierman
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Rachel S. Gross
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| |
Collapse
|
48
|
Knappe S, Pfarr AL, Petzoldt J, Härtling S, Martini J. Parental Cognitions About Sleep Problems in Infants: A Systematic Review. Front Psychiatry 2020; 11:554221. [PMID: 33408648 PMCID: PMC7779594 DOI: 10.3389/fpsyt.2020.554221] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 11/20/2020] [Indexed: 12/17/2022] Open
Abstract
Introduction: Parental cognitions may directly and indirectly contribute to infant sleep outcomes. This review provides a systematic up-to-date overview of the associations between parental cognitions and infant sleep problems with special emphasis on temporal relationships and the content of parental cognitions. Methods: A systematic literature research in PubMed and Web of Science Core Collection sensu Liberati and PRISMA guidelines was carried out in March 2020 using the search terms (parent* AND infant* AND sleep* problem*), including studies with correlational or control group designs investigating associations between parental cognitions and sleep problems in children aged 1-6 years. Results: Twenty-three studies (published from 1985 to 2016) met inclusion criteria, of which 14 reported group differences or associations between parental sleep-related cognitions and child sleep outcomes. Nine papers additionally reported on the role of general parental child-related cognitions not directly pertaining to sleep. Findings from longitudinal studies suggest that parental cognitions often preceded child sleep problems. Cognitions pertaining to difficulties with limit-setting were especially prevalent in parents of poor sleepers and were positively associated with both subjective and objective measures of child sleep outcomes. Conclusions: Parental cognitions appear to play a pivotal role for the development and maintenance of sleep problems in young children, arguing that parents' attitudes and beliefs regarding child sleep inadvertently prompts parental behavior toward adverse sleep in offspring. Associations are however based on maternal reports and small to moderate effect sizes. Thus, additional parental factors such as mental health or self-efficacy, as well as additional offspring factors including temperamental dispositions and regulatory abilities, require consideration in further studies.
Collapse
Affiliation(s)
- Susanne Knappe
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Anna-Lisa Pfarr
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Johanna Petzoldt
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Samia Härtling
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,University of Meißen (FH) and Centre of Further Education, Meißen, Germany
| | - Julia Martini
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine, Carl Gustav Carus University Hospital, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
49
|
Abstract
In this section, a range of brief synopses of recently published articles that may be of interest to health visitors is presented. The aim of this roundup is to provide an overview, rather than a detailed summary, of the research papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided.
Collapse
Affiliation(s)
- Odd Dawn
- Senior Lecturer Specialist Community Public Health Nursing, UWE Bristol
| | - Patricia Poole
- Associate Lecturer, Specialist Community Public Health Nursing, UWE Bristol
| | | |
Collapse
|
50
|
Douglas PS. Pre-emptive Intervention for Autism Spectrum Disorder: Theoretical Foundations and Clinical Translation. Front Integr Neurosci 2019; 13:66. [PMID: 31798425 PMCID: PMC6877903 DOI: 10.3389/fnint.2019.00066] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 11/04/2019] [Indexed: 12/28/2022] Open
Abstract
Autism spectrum disorders (ASD) are an emergent public health problem, placing significant burden upon the individual, family and health system. ASD are polygenetic spectrum disorders of neural connectome development, in which one or more feedback loops amplify small genetic, structural, or functional variations in the very early development of motor and sensory-motor pathways. These perturbations trigger a 'butterfly effect' of unpredictable cascades of structural and functional imbalances in the global neuronal workspace, resulting in atypical behaviors, social communication, and cognition long-term. The first 100 days post-term are critically neuroplastic and comprise an injury-sensitive developmental window, characterized by a neural biomarker, the persistence of the cortical subplate, and a behavioral biomarker, the crying diathesis. By the time potential diagnostic signs are identified, from 6 months of age, ASD neuropathy is already entrenched. The International Society for Autism Research Special Interest Group has called for pre-emptive intervention, based upon rigorous theoretical frames, and real world translation and evaluation. This paper responds to that call. It synthesizes heterogenous evidence concerning ASD etiologies from both psychosocial and biological research literatures with complexity science and evolutionary biology, to propose a theoretical framework for pre-emptive intervention. This paper hypothesizes that environmental factors resulting from a mismatch between environment of evolutionary adaptedness and culture initiate or perpetuate early motor and sensory-motor lesions, triggering a butterfly effect of multi-directional cascades of atypical developmental in the complex adaptive system of the parent and ASD-susceptible infant. Chronic sympathetic nervous system/hypothalamic-pituitary-adrenal axis hyperarousal and disrupted parent-infant biobehavioral synchrony are the key biologic and behavioral mechanisms perpetuating these atypical developmental cascades. A clinical translation of this evidence is proposed, for application antenatally and in the first 6 months of life, as pre-emptive intervention for ASD.
Collapse
Affiliation(s)
- Pamela S. Douglas
- Transforming Maternity Care Collaborative, Griffith University, Brisbane, QLD, Australia
- Discipline of General Practice, The University of Queensland, Brisbane, QLD, Australia
| |
Collapse
|